Corynebacterium Infection Following Implant-based Breast Reconstruction: Lessons from the Five Consecutive Patients

Abstract

Background Infection is a challenging complication in prosthetic breast reconstruction. Recently, we encountered cases of Corynebacterium striatum infection following prosthetic breast reconstruction in breast cancer patients. We would like to share our experience of preventing reconstruction failure from this uncommon infection. Methods This is a retrospective study on consecutive cases of Corynebacterium infection that occurred within 2 months in five patients who underwent implant-based breast reconstruction. One patient had a history of preoperative radiation therapy, one required reoperation due to postoperative bleeding, and two experienced hemovac obstruction events. Patients were immediately hospitalized and treated with hemovac insertion, IV antibiotics, and, if necessary, reoperation for salvage. Results Corynebacterium striatum was identified in the hemovac cultures or intraoperative specimens of all patients. Based on the antibiotic susceptibility of the identified strain, infection with a single bacterial strain was suspected. All patients underwent hemovac re-insertion, and one patient was successfully salvaged with IV antibiotic treatment alone. However, the remaining four patients required implant change during the salvage process. The bacteria became negative within a period ranging from 1 to 7 weeks after identification, and salvage was successfully achieved without reconstruction failure in all patients by postoperative days 20 to 58. Conclusion Corynebacterium is an uncommon pathogen in implant-based breast reconstruction, and reports of its treatment are very rare. This study presents our experience with successful treatment and outlines the clinical symptoms and treatment methods. We hope that this report can serve as a reference for reconstructive surgeons who may encounter similar situations.