Etiology of granulomatous lobular mastitis based on metagenomic next-generation sequencing

Abstract

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Clinical characteristics and therapeutic strategy of Granulomatous mastitis accompanied by Corynebacterium kroppenstedtii —— a retrospective cohort study

“…versus the control group (28 patients with no evidence of Corynebacteria) and found that the formation of draining sinuses was the statistically signi cant differences between the two group and was more frequent in the case group [1]. Bi JX et al found 16 of 25 (64.00%) patients diagnosed as GM in their study were accompanied by skin ulceration and pus, and 9 of them (56.25%) accompanied by skin ulceration had the pathogen of C. kroppenstedtii [34]. Corynebacterium kroppenstedtii preferred to grow and proliferate in lipid-rich areas of breast including the subcutaneous, rstly forming small and scattered localized abscesses, then gradually expanding and in ltrating the subcutaneous and forming sinuses.…”

Udder Health Monitoring for Prevention of Bovine Mastitis and Improvement of Milk Quality

“…As next-generation sequencing (NGS) is becoming more accessible and less expensive, a new opportunity for developing novel genotyping tools to detect mastitis infectious pathogens arises. Studies have shown that target-specific primers for PCR-mediated amplification with NGS technology to enrich and accurately sequence pathogen genomic areas of interest may contribute to identifying pathogens that were overlooked by other methods [ 173 , 174 , 175 ]. This outcome indicates the NGS’s practicability and suggests that it is possible to integrate this technique as a diagnostic tool into a veterinary diagnostic laboratory in a cost-effective manner and that in the near future, NGS sequencing can be used as a tool in routine identification of mastitis-related microorganisms [ 124 ].…”

The Emerging Role of Corynebacteria in the Pathogenesis of Granulomatous Lobular Mastitis

“…Supplementing lipophilic antibiotics with prolactin inhibitors and cessation of lactation may result in a more effective response. 16 In conclusion, there is substantial scientific evidence pointing towards the pathogenicity of Corynebacterium kroppenstedtii in GLM. We recommend obtaining fresh breast aspirates and/or tissues for microbial studies in all patients with suspected GLM.…”

“…This raises the question of whether Corynebacterium kroppenstedtii is the only pathogen in GLM or is it a polymicrobial process. In a more recent study, Jiaxin Bi et al, 16 studied the infectious landscape of GLM using metagenomic next-generation sequencing (mNGS) -a new and powerful platform capable of identifying nucleic acids from multiple different species, unlike targeted PCRs that are speciesspecific. Their study detected pathogens in 17 of 25 GLM cases out of which 14 (82.3%) were Corynebacterium kroppenstedtii.…”

“…In recent years, several studies describing successful treatment of GLM with lipophilic antibiotics with a high volume of distribution such as rifampicin, doxycycline, trimethoprim-sulfamethoxazole, and clarithromycin have been described. 16,[18][19][20][21][22] Additionally, being a lipophilic bacterium, Corynebacterium kroppenstedtii thrives in lipid-rich states such as hyperprolactinemia and lactation. Supplementing lipophilic antibiotics with prolactin inhibitors and cessation of lactation may result in a more effective response.…”