30–Year–Old Diagnosed With Infection Three Yrs After Surgery

When a new mother from south Mumbai sought medical help for significant distortion of her right breast, the term super-bug never crossed her mind. But she may be the most telling example of poor infection control in Indian hospitals andtheensuing threat to patients undergoing surgeries.

The 30–year–old, who had breast implants in 2009, was found to have an MRSA infection. MRSA (Methicillin–Resistant Staphylococcus Aureus) is one of the most potent super-bugs or bacteria resistant to antibiotics.

The woman’s right breast was not only more than double the left, it was also lumpy and painful. An evaluation revealedshefirstexperiencedfirmness in her breast six months after the surgery, but thought it was a result of her pregnancy. The firmness worsened after she started breast7nd feeding.

It was only when the doctors did an MRI scan did they realize that there was an infection in the lining (capsule) of the implant. "The MRI scan showed she was suffering from capsular contracture," said Dr Mohan Thomas, consultant cosmetic surgeon at Breach Candy Hospital. "She had the cosmetic surgery in another hospital. By the time she came to us, the capsule (implant lining) of her right breast was about12 mm," hesaid, adding a normal lining is not beyond 2mm in thickness. The body tissues form a protective lining around an implant, referred to as the "capsule". In some women, however, the capsule shrinks, referred to as capsular contracture.

It was only after her surgery that the reason for the contracture was found. "During the surgery, a large amount of pus and fluid kept oozing out of her breast. After surgery, we sent the fluid for examination and it turned out to be MRSA," said Dr Thomas. While clinical tests showed no signs of the infection, the fluid in the capsules showed the presence of the pathogens.

"If this pathogen had spread across the body, it could have killed her. But in her case, her capsule had taken the whole burden of this pathogen," said Dr Thomas.