Staphylococcus lugdunensis Infections: High Frequency of Inguinal Area Carriage

Abstract

Following a change in surgical practice, we noted that the rate at which Staphylococcus lugdunensis was isolated from samples from the plastic surgery unit of our hospital increased considerably. We investigated the sources of these S. lugdunensis strains, and we found that in the case of drain colonization or surgical site infection, the strain was more likely to have come from the patient's skin bacteria when the pubic site had been shaved preoperatively. To test the hypothesis of pubic site colonization, we evaluated the prevalence of S. lugdunensis carriage among the cutaneous flora of the inguinal area. We found that 22% of 140 incoming patients carried S. lugdunensis in this area and that carriage at both inguinal folds was frequent (68% of carriers). A study of the genetic structure of the total population, including the clinical (n ‫؍‬ 18) and the commensal (n ‫؍‬ 53) strains, revealed that the diversity of the species was low and that the population was composed of two major groups that diverged at a distance of 35%. No particular characteristics made it possible to distinguish between clinical and commensal strains. Only isolates producing ␤-lactamase were homogeneous; six of the eight ␤-lactamase-positive strains displayed the same pulsed-field gel electrophoresis pattern.Staphylococcus lugdunensis is a coagulase-negative Staphylococcus (CoNS) that was first described by Freney et al. (9) in 1988 and that has the potential to be an opportunistic pathogen. S. lugdunensis is an unusually virulent CoNS and can cause many types of infection, ranging from superficial skin infections to life-threatening endocarditis. Most laboratory isolates are collected from colonized patients or patients with primary skin infections or minor postoperative wound infections. Nevertheless, S. lugdunensis has been shown to be associated with serious infections such as breast abscesses (18, 34), peritonitis (19, 28), infected joint prostheses (26, 35), osteomyelitis (22), discitis (2), septic arthritis (12), and pacemaker infections (1,3,16). Unlike S. epidermidis, which usually results in indolent subacute infections, S. lugdunensis results in acute infections, similar to S. aureus. S. lugdunensis infections typically resemble S. aureus infections in terms of the virulence of the organism and the clinical course of infection, which is often highly destructive (28, 31, 33).S. lugdunensis can act as an etiologic agent of infective endocarditis. It may infect both prosthetic and native valves (31). Patel et al. (24) found that S. lugdunensis accounted for 18% of CoNS strains causing infective endocarditis and 44% of CoNS strains causing native valve endocarditis. The mortality rate as a result of endocarditis caused by S. lugdunensis is high (7,15,31). Few studies have looked at the epidemiology and ecology of S. lugdunensis. Similar to other CoNS strains, S. lugdunensis is considered part of the resident flora of the entire surface of the human skin and mucous membranes (11). No detailed studies have been carried out on the d...

Laboratory and Clinical Characteristics of Staphylococcus lugdunensis Prosthetic Joint Infections

“…In this study, 32% of the episodes had a urogenital abnormality. This finding is reinforced by the findings previously presented in case reports (8,10,16,17,21). It is important to point out that our study cannot definitively associate these urogenital abnormalities with patients who have S. lugdunensis PJIs, given the design of a single-cohort study.…”

“…This organism is considered part of the normal flora of human skin, and it has been reported to be present in the perineum and inguinal area as well (10,16,17,21). In addition, this organism is capable of producing diseases similar to those caused by S. aureus.…”

Characterization of the fibrinogen-binding surface protein Fbl of Staphylococcus lugdunensis

“…When similar analysis was performed with clfA, many different sizes of R region were observed, a feature that reflects the more diverse population structure of S. aureus shown by PFGE van der Mee-Marquet et al, 2003).…”

“…It is a commensal of human skin and can occasionally cause serious invasive infections such as osteomyelitis, peritonitis, soft tissue abscesses and infective endocarditis, diseases that are more usually associated with Staphylococcus aureus (Van der Mee-Marquet et al, 2003;Bellamy & Barkham 2002;Kragsbjerg et al, 2000). S. lugdunensis accounts for 18 % of infective endocarditis and 44 % of native valve endocarditis caused by CoNS (Patel et al, 2000).…”

Microbiota of freshwater catfish species, Filhote (Brachyplatystoma filamentosum) and Dourada (Brachyplatystoma rousseauxii) from the Amazon Region (Belm-Par-Brazil)

“…S. xylosus have been identified in high numbers in dried salted cod (Vilhelmsson et al, 1997;Doe and Heruwati, 1988) and are rarely associated with human or animal infections (Kloos and Schleifer, 1986). S. lugdunensis is a common human skin commensal (Bellamy and Barkham, 2002;Vandenesch et al, 1995;Van der Mee-Marquet, 2003). These bacteria display pathogen characteristics, although they do not belong to this group, and exhibit pathogenicity similar to Staphylococcus aureus, with high associated morbidity and mortality (Cercenado, 2009;Frank and Patel, 2008;Poutanen and Baron, 2001).…”