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

Reference

1. Argemi X, Hansmann Y, Riegel P, Prévost G. Is Staphylococcus lugdunensis significant in clinical samples? J Clin Microbiol. 2017; 55:3167–3174.
Article
2. Frank KL, Del Pozo JL, Patel R. From clinical microbiology to infection pathogenesis: how daring to be different works for Staphylococcus lugdunensis . Clin Microbiol Rev. 2008; 21:111–133.
Article
3. Choi SH, Chung JW, Lee EJ, Kim TH, Lee MS, Kang JM, Song EH, Jun JB, Kim MN, Kim YS, Woo JH, Choi SH. Incidence, characteristics, and outcomes of Staphylococcus lugdunensis bacteremia. J Clin Microbiol. 2010; 48:3346–3349.
Article
4. Böcher S, Tønning B, Skov RL, Prag J. Staphylococcus lugdunensis, a common cause of skin and soft tissue infections in the community. J Clin Microbiol. 2009; 47:946–950.
Article
5. Liu PY, Huang YF, Tang CW, Chen YY, Hsieh KS, Ger LP, Chen YS, Liu YC. Staphylococcus lugdunensis infective endocarditis: a literature review and analysis of risk factors. J Microbiol Immunol Infect. 2010; 43:478–484.
Article
6. Sampathkumar P, Osmon DR, Cockerill FR 3rd. Prosthetic joint infection due to Staphylococcus lugdunensis . Mayo Clin Proc. 2000; 75:511–512.
7. Becker K, Heilmann C, Peters G. Coagulase-negative staphylococci. Clin Microbiol Rev. 2014; 27:870–926.
Article
8. Haile DT, Hughes J, Vetter E, Kohner P, Snyder R, Patel R, Cockerill FR 3rd. Frequency of isolation of Staphylococcus lugdunensis in consecutive urine cultures and relationship to urinary tract infection. J Clin Microbiol. 2002; 40:654–656.
Article
9. Nesher L, Tarrand J, Chemaly RF, Rolston KV. Staphylococcus lugdunensis infections, filling in the gaps: a 3-year retrospective review from a comprehensive cancer center. Support Care Cancer. 2017; 25:1063–1069.
Article
10. Noguchi N, Fukuzawa M, Wajima T, Yokose K, Suzuki M, Nakaminami H, Kawai T, Moriyasu F, Sasatsu M. Specific clones of Staphylococcus lugdunensis may be associated with colon carcinoma. J Infect Public Health. 2018; 11:39–42.
Article
11. Kleiner E, Monk AB, Archer GL, Forbes BA. Clinical significance of Staphylococcus lugdunensis isolated from routine cultures. Clin Infect Dis. 2010; 51:801–803.
Article
12. Papapetropoulos N, Papapetropoulou M, Vantarakis A. Abscesses and wound infections due to Staphylococcus lugdunensis: report of 16 cases. Infection. 2013; 41:525–528.
Article
13. Zinkernagel AS, Zinkernagel MS, Elzi MV, Genoni M, Gubler J, Zbinden R, Mueller NJ. Significance of Staphylococcus lugdunensis bacteremia: report of 28 cases and review of the literature. Infection. 2008; 36:314–321.
Article
14. Non LR, Santos CA. The occurrence of infective endocarditis with Staphylococcus lugdunensis bacteremia: a retrospective cohort study and systematic review. J Infect. 2017; 74:179–186.
Article
15. Fadel HJ, Patel R, Vetter EA, Baddour LM. Clinical significance of a single Staphylococcus lugdunensis-positive blood culture. J Clin Microbiol. 2011; 49:1697–1699.
Article
16. Ebright JR, Penugonda N, Brown W. Clinical experience with Staphylococcus lugdunensis bacteremia: a retrospective analysis. Diagn Microbiol Infect Dis. 2004; 48:17–21.
Article
17. Yeh CF, Chang SC, Cheng CW, Lin JF, Liu TP, Lu JJ. Clinical features, outcomes, and molecular characteristics of community- and health care-associated Staphylococcus lugdunensis infections. J Clin Microbiol. 2016; 54:2051–2057.
Article
18. Tan TY, Ng SY, He J. Microbiological characteristics, presumptive identification, and antibiotic susceptibilities of Staphylococcus lugdunensis. J Clin Microbiol. 2008; 46:2393–2395.
Article
Full Text Links
  • IC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr