Abscesses and wound infections due to Staphylococcus lugdunensis: report of 16 cases

Papapetropoulos, Nektarios; Papapetropoulou, M.; Vantarakis, Apostolos

doi:10.1007/s15010-012-0381-z

Cited by 27 publications

(18 citation statements)

References 22 publications

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“…Similarly, although nearly all isolates were oxacillin susceptible, only 44.4% of patients with a clinically significant, oxacillin-susceptible isolate were narrowed to a ␤-lactam. Other studies have documented higher rates of penicillin prescription, perhaps highlighting differences in regional/institutional practices or drug availability/pricing (26,29,30). In addition, resistance to non-␤-lactam drugs was observed, including erythromycin and clindamycin, which has also been noted previously (18,31).…”

Section: Discussionmentioning

confidence: 61%

Clinical and Microbiological Aspects of β-Lactam Resistance in Staphylococcus lugdunensis

et al. 2017

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Antimicrobial susceptibility results from broth microdilution MIC testing of 993 Staphylococcus lugdunensis isolates recovered from patients at a tertiary care medical center from 2008 to 2015 were reviewed. Ninety-two oxacillin-susceptible isolates were selected to assess the accuracy of penicillin MIC testing, the penicillin disk diffusion test, and three ␤-lactamase tests, including the cefoxitin-induced nitrocefin test, penicillin cloverleaf assay, and penicillin disk zone edge test. The results of all phenotypic tests were compared to the results of blaZ PCR. The medical records of 62 patients from whom S. lugdunensis was isolated, including 31 penicillinsusceptible and 31 penicillin-resistant strains, were retrospectively reviewed to evaluate the clinical significance of S. lugdunensis isolation, the antimicrobial agents prescribed, if any, and the clinical outcome. MIC testing revealed that 517/993 (52.1%) isolates were susceptible to penicillin and 946/993 (95.3%) were susceptible to oxacillin. The induced nitrocefin test was 100% sensitive and specific for the detection of ␤-lactamase compared to the blaZ PCR results, whereas the penicillin disk zone edge and cloverleaf tests showed sensitivities of 100% but specificities of only 9.1% and 89.1%, respectively. The penicillin MIC test had 100% categorical agreement with blaZ PCR, while penicillin disk diffusion yielded one major error. Only 3/31 patients with penicillin-susceptible isolates were treated with a penicillin family antimicrobial. The majority of cases were treated with other ␤-lactams, trimethoprimsulfamethoxazole, or vancomycin. These data indicate that nearly all isolates of S. lugdunensis are susceptible to narrow-spectrum antimicrobial agents. Clinical laboratories in areas with resistance levels similar to those described here can help promote the use of these agents versus vancomycin by effectively designing their antimicrobial susceptibility reports to convey this message.KEYWORDS Staphylococcus, antimicrobial resistance, beta-lactams, lugdunensis S taphylococcus spp. are normal skin flora inhabitants and, in some cases, opportunistic human pathogens (1). The coagulase-negative staphylococci (CoNS) are typically less virulent than Staphylococcus aureus in healthy human hosts. One exception is Staphylococcus lugdunensis, which may exhibit increased virulence compared to that of other CoNS (2). Infections associated with S. lugdunensis can include skin and soft tissue infections, native valve endocarditis, urinary tract infections, and prosthetic device infections (2).Isolates of CoNS, in particular Staphylococcus epidermidis, that harbor the mecA gene can have oxacillin MICs in the 0.5-to 2.0-g/ml range, which is much lower than the oxacillin MICs observed in mecA-positive isolates of S. lugdunensis and S. aureus (3-7). As such, the Clinical and Laboratory Standards Institute (CLSI) recommends that

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Section: Discussionmentioning

confidence: 61%

Clinical and Microbiological Aspects of β-Lactam Resistance in Staphylococcus lugdunensis

et al. 2017

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“…10 Although S. lugdunensis is said to behave like S. aureus, its preferred sites of colonisation and subsequent sites of infection differ dramatically. Similarly, a variable antibiotic resistance profile due to the production of beta lactamase and penicillin resistance has been shown, 9 with traditional antibiotics often being ineffective in treating infection with S. lugdunensis. This further highlights the need for the careful consideration of this organism in the appropriate clinical setting, allowing for its subsequent identification, speciation and targeted treatment.…”

Section: Discussionmentioning

confidence: 99%

Staphylococcus lugdunensis: case report and discussion

Donoghue

Vekic

Wehrhahn

et al. 2014

Australasian Journal of Dermatology

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“…Described as a "wolf in sheep's clothing," S. lugdunensis resembles Staphylococcus aureus in its clinical presentation and course of infection (tissue destruction and aggressive clinical course) (2). Even if it can cause many types of infections ranging from localized to systemic (2,5,6), this opportunistic pathogen has been mainly associated with serious infections, such as skin and soft tissue infections (SSTI) (3,4,7,8), infective endocarditis (5, 6, 9, 10), abscesses (11,12), and bone and joint infections (13,14). S. lugdunensis SSTI have been reported to be superficial, painful, often prolonged, and recurrent in patients with skin diseases or after trauma or surgery (7,15).…”

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confidence: 99%

Multi-Virulence-Locus Sequence Typing of Staphylococcus lugdunensis Generates Results Consistent with a Clonal Population Structure and Is Reliable for Epidemiological Typing

et al. 2014

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cStaphylococcus lugdunensis is an emergent virulent coagulase-negative staphylococcus responsible for severe infections similar to those caused by Staphylococcus aureus. To understand its potentially pathogenic capacity and have further detailed knowledge of the molecular traits of this organism, 93 isolates from various geographic origins were analyzed by multi-virulence-locus sequence typing (MVLST), targeting seven known or putative virulence-associated loci (atlL R2 , atlL R3 , hlb, isdJ, SLUG_09050, SLUG_16930, and vwbl). The polymorphisms of the putative virulence-associated loci were moderate and comparable to those of the housekeeping genes analyzed by multilocus sequence typing (MLST). However, the MVLST scheme generated 43 virulence types (VTs) compared to 20 sequence types (STs) based on MLST, indicating that MVLST was significantly more discriminating (Simpson's index [D], 0.943). No hypervirulent lineage or cluster specific to carriage strains was defined. The results of multilocus sequence analysis of known and putative virulence-associated loci are consistent with a clonal population structure for S. lugdunensis, suggesting a coevolution of these genes with housekeeping genes. Indeed, the nonsynonymous to synonymous evolutionary substitutions (d N /d S ) ratio, the Tajima's D test, and Single-likelihood ancestor counting (SLAC) analysis suggest that all virulence-associated loci were under negative selection, even atlL R2 (AtlL protein) and SLUG_16930 (FbpA homologue), for which the d N /d S ratios were higher. In addition, this analysis of virulence-associated loci allowed us to propose a trilocus sequence typing scheme based on the intragenic regions of atlL R3 , isdJ, and SLUG_16930, which is more discriminant than MLST for studying short-term epidemiology and further characterizing the lineages of the rare but highly pathogenic S. lugdunensis.

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Abscesses and wound infections due to Staphylococcus lugdunensis: report of 16 cases

Cited by 27 publications

References 22 publications

Clinical and Microbiological Aspects of β-Lactam Resistance in Staphylococcus lugdunensis

Clinical and Microbiological Aspects of β-Lactam Resistance in Staphylococcus lugdunensis

Staphylococcus lugdunensis: case report and discussion

Multi-Virulence-Locus Sequence Typing of Staphylococcus lugdunensis Generates Results Consistent with a Clonal Population Structure and Is Reliable for Epidemiological Typing

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