Breast Abscess and Staphylococcal Disease in a Maternity Hospital

This report concerns the occurrence of breast abscess in 18,275 mothers delivered in the 95-bed maternity unit of the Geelong and District Hospital between July 1956 and December 1963.A reduction in the incidence of puerperal breast abscess from 2.5% to 0.16% of mothers delivered during this time is reported and factors responsible are discussed.Geelong is a rural industrial city of approximately 100,000 inhabitants.The city and surrounding district are well defined and depend on the Geelong and District Hospital for all maternity beds and more than 90% of general-hospital beds.This centralization of medical services greatly facilitated an almost complete follow-up investigation of mothers and babies for a period of six months after delivery.In addition, all medical practitioners in the area co-operated fully in this survey by making their private records available and completing questionaries circulated to them at three-monthly intervals.Further information was gained by checking private and public hospital records, the records of infant health centres, and by personal contact of mothers after discharge home by visits, telephone, or posted questionaries.The term " puerperal breast abscess " is used to denote any inflammatory condition, of either breast, which occurred within six months of delivery, and which resulted in suppuration or required incision.Staphylococcal skin disease includes pustules, paronychia, abscesses, rashes, and any other skin lesions from which staphylococci were grown on culture.Minimal observer variation has occurred during the survey.All aspects have been continually supervised by one or other of us.Three of the four floors in the maternity wing have had the same sister-in-charge throughout the survey.Many other aspects of this study, including basic nursery techniques and bacteriological methods used, have been reported in previous papers (Plueckhahn, 1961; Plueckhahn and Banks, 1958, 1961, 1963).Any reference to the staphylococcus refers to a coagulase-positive Staphylococcus aureus unless otherwise stated. ResultsThe results of certain aspects of this survey are shown in Tables I to XII.