Infect Chemother.  2019 Mar;51(1):45-53. 10.3947/ic.2019.51.1.45.

A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States

Affiliations
  • 1Department of General Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
  • 2Division of Infectious Disease, Department of General Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
  • 3Division of International Medicine, Department of General Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
  • 4Department of Internal Medicine and Oncologic Sciences, H. Lee Moffitt Cancer Center, Morsani College of Medicine University of South Florida, Tampa, FL, USA.
  • 5Infectious Diseases and Hospital Epidemiologist, Moffitt Cancer Center and Research Institute, Tampa, FL, USA. John.Greene@moffitt.org

Abstract

BACKGROUND
Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CoNS) that is a part of the normal human skin flora. Even though it belongs to CoNS family, it can cause severe and destructive infections in a similar fashion to Staphylococcus aureus. Skin and soft tissue infections (SSTI), bacteremia and endocarditis are amongst the most common clinical presentations. Diagnosis and clinical presentation of infections caused by S. lugdunensis in cancer patients is limited.
MATERIALS AND METHODS
We performed a retrospective chart review of 24 patients who had cultures positive for S. lugdunensis. Out of 24 patients, 14 patients were diagnosed with a true infection and 10 other patients were considered to be colonized with this pathogen. We analyzed clinical manifestation, treatment and response to therapy.
RESULTS
SSTI was the most common presentation in our study patients. All patients diagnosed with SSTI had a prior surgery or an invasive procedure at the affected site. Five urinary tract infections (UTIs), one catheter-associated bloodstream infection, and a deep pelvic abscess were other reported infections in our study. We observed that S. lugdunensis remains susceptible to a variety of antibiotics, with all isolates susceptible to vancomycin and linezolid and most remain susceptible to fluoroquinolone and trimethoprim/ sulfamethoxazole. All 14 patients received antibiotics and improved.
CONCLUSION
In our case series, SSTI was common and diagnosed in 50% of the patients with clinically significant isolates for S. lugdunensis. This is consistent with prior studies indicating that S. lugdunensis is a significant pathogen in SSTIs. UTI was the second most common infection type in our patient population.

Keyword

Staphylococcus lugdunensis; Coagulase-negative Staphylococcus; Bacteremia; Infection; Cancer

MeSH Terms

Abscess
Anti-Bacterial Agents
Bacteremia
Colon
Diagnosis
Endocarditis
Humans
Linezolid
Retrospective Studies
Skin
Soft Tissue Infections
Staphylococcus aureus
Staphylococcus lugdunensis*
Staphylococcus*
Sulfamethoxazole
United States*
Urinary Tract Infections
Vancomycin
Anti-Bacterial Agents
Linezolid
Sulfamethoxazole
Vancomycin
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