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Laboratory: Clinical Microbiology
Test Name:
Test Code: FLU
Clinical Information:
Test Indications:
An aid in the diagnosis of severe, refractory, or hospital-acquired mastitis.

The diagnosis of mastitis is usually clinical, with patients presenting with unilateral breast tenderness and erythema, accompanied by a fever of 38.5°C, malaise, fatigue, body aches, and headache.
Aerobic bacterial culture of breast milk can be useful to guide selection of antibiotics in severe cases.  S. aureus is the most common etiology; beta-hemolytic Streptococcus, Candida albicans, coagulase negative Staphylococcus, or Gram-negative bacilli may occasionally be implicated in disease.
Positive cultures can result from normal bacterial colonization, and negative cultures do not rule out mastitis.
Breast milk is not a suitable specimen for the diagnosis of breast abscess, or other complications of mastitis.
Routine culture of breast milk to screen for infectious bacteria is not recommended.

Patient Preparation Instructions:
1.  Place a towel in the patient's lap prior to irrigation.
2.  Prior to milk expression, irrigate the nipple with sterile saline.
3.  Blot the nipple with sterile gauze after irrigation
4.  Cleanse each nipple with an alcohol wipe.  Allow alcohol to dry.
Collection Devices:
Specimen Required: Breast Milk:  3-5 mL of expressed breast milk.
First few mL of breast milk may be contaminated and should not be collected.
Reference Values:
Negative: “No growth” OR “Normal skin flora”.
Positive: A descriptive report will be sent for significant pathogens.
See Also:
More Information:
Specimen Handling:
If transport time >2 hours is anticipated, the specimen should be kept at 4°C.