From Clinical Microbiology to Infection Pathogenesis: How Daring To Be Different Works forStaphylococcus lugdunensis

Abstract

SUMMARY Staphylococcus lugdunensis has gained recognition as an atypically virulent pathogen with a unique microbiological and clinical profile. S. lugdunensis is coagulase negative due to the lack of production of secreted coagulase, but a membrane-bound form of the enzyme present in some isolates can result in misidentification of the organism as Staphylococcus aureus in the clinical microbiology laboratory. S. lugdunensis is a skin commensal and an infrequent pathogen compared to S. aureus and S. epidermidis, but clinically, infections caused by this organism resemble those caused by S. aureus rather than those caused by other coagulase-negative staphylococci. S. lugdunensis can cause acute and highly destructive cases of native valve endocarditis that often require surgical treatment in addition to antimicrobial therapy. Other types of S. lugdunensis infections include abscess and wound infection, urinary tract infection, and infection of intravascular catheters and other implanted medical devices. S. lugdunensis is generally susceptible to antimicrobial agents and shares CLSI antimicrobial susceptibility breakpoints with S. aureus. Virulence factors contributing to this organism's heightened pathogenicity remain largely unknown. Those characterized to date suggest that the organism has the ability to bind to and interact with host cells and to form biofilms on host tissues or prosthetic surfaces.

Staphylococcus lugdunensis: case report and discussion

“…11 It is reported to represent 5 to 6% of coagulase-negative staphylococci isolated from skin lesions, with S. lugdunensis more likely than S. epidermidis or other CoNS to be clinically significant when isolated from superficial infections. 1 The commensal role of S. lugdunensis was examined in Sweden in 2009 when multiple body sites of 75 healthy individuals were swabbed, including the nose, axillae, perineum, groin, breast and toes.…”

Urinary tract infection due to Staphylococcus lugdunensis in a 70-year-old woman with cystocele grade 3

“…lugdunensis is a CoNS that has considerable potential as an opportunistic pathogen of humans (Bannerman & Peacock, 2007;Frank et al, 2008). Urinary isolates of S. lugdunensis have been reported previously, but the exact significance of S. lugdunensis in the urine remains unclear (Haile et al, 2002).…”

“…A single monomicrobial case of clearcut UTI has been reported (Casanova-Roman et al, 2004). The clinical course and virulence of infections due to S. lugdunensis are known to resemble that of infections due to S. aureus (Frank et al, 2008). S. lugdunensis is commonly found on the human skin.…”

“…Equally surprising, compared with CoNS, most S. lugdunensis isolates remain susceptible to a large number of antimicrobial agents (Frank et al, 2007). With little doubt, S. lugdunensis cannot be considered a 'typical' CoNS, and its successful position as an unusually virulent pathogen deserves attention (Frank et al, 2008). It has rarely been reported to cause urinary tract infections, and then predominantly in adults as part of mixed flora (Haile et al, 2002).…”

“…S. lugdunensis is commonly found on the human skin and is a rare contaminant in cultures (Seenivasan & Yu, 2003). S. lugdunensis, named after Lyon, France, the city where the organism was initially isolated (Fleurette et al, 1989), has emerged as an important human pathogen with notable clinical and microbiological characteristics that stand out among those of other CoNS (Frank et al, 2008). Described previously as 'surreptitious' (Sotutu et al, 2002) and a 'wolf in sheep's clothing', S. lugdunensis behaves more like S. aureus than other CoNS in many respects, including exhibiting an elevated degree of virulence.…”