Methicillin-resistant Staphylococcus lugdunensis carrying SCCmec type V misidentified as MRSA

Pereira, Elisabete Monteiro de Aguiar; Schuenck, Ricardo Pinto; Nouér, Simone Aranha; Santos, Kátia Regina Netto dos

doi:10.1590/s1413-86702011000300020

Cited by 4 publications

(5 citation statements)

References 8 publications

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“…No SCCmec type IV, V, or Vt isolate was identified in cases of CA S. lugdunensis infection. Only one case of CA oxacillin-resistant S. lugdunensis SCCmec type V infection has been reported to date, in Brazil (27). This finding suggests that the rate of oxacillin resistance in S. lugdunensis remains low in the community.…”

Section: Discussionmentioning

confidence: 97%

Clinical Features, Outcomes, and Molecular Characteristics of Community- and Health Care-Associated Staphylococcus lugdunensis Infections

et al. 2016

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Staphylococcus lugdunensis is a major cause of aggressive endocarditis, but it is also responsible for a broad spectrum of infections. The differences in clinical and molecular characteristics between community-associated (CA) and health care-associated (HA) S. lugdunensis infections have remained unclear. We performed a retrospective study of S. lugdunensis infections between 2003 and 2014 to compare the clinical and molecular characteristics of CA and HA isolates. We collected 129 S. lugdunensis isolates in total: 81 (62.8%) HA isolates and 48 (37.2%) CA isolates. HA infections were more frequent than CA infections in children (16.0% versus 4.2%, respectively; P ‫؍‬ 0.041) and the elderly (38.3% versus 14.6%, respectively; P ‫؍‬ 0.004). The CA isolates were more likely to cause skin and soft tissue infections (85.4% versus 19.8%, respectively; P < 0.001). HA isolates were more frequently responsible for bacteremia of unknown origin (34.6% versus 4.2%, respectively; P < 0.001) and for catheter-related bacteremia (12.3% versus 0%, respectively; P ‫؍‬ 0.011) than CA isolates. Fourteen-day mortality was higher for HA infections than for CA infections (11.1% versus 0%, respectively). A higher proportion of the HA isolates than of the CA isolates were resistant to penicillin (76.5% versus 52.1%, respectively; P ‫؍‬ 0.004) and oxacillin (32.1% versus 2.1%, respectively; P < 0.001). Two major clonal complexes (CC1 and CC3) were identified. Sequence type 41 (ST41) was the most common sequence type identified (29.5%). The proportion of ST38 isolates was higher for HA than for CA infections (33.3% versus 12.5%, respectively; P ‫؍‬ 0.009). These isolates were of staphylococcal cassette chromosome mec element (SCCmec)type IV, V, or Vt. HA and CA S. lugdunensis infections differ in terms of their clinical features, outcome, antibiotic susceptibilities, and molecular characteristics. S taphylococcus lugdunensis was first described by Freney et al. in 1988 (1). It has emerged as an important human pathogen in recent years, due to its ability to cause endocarditis and a broad spectrum of other infections, including skin and soft tissue infections, bloodstream infections, bone and joint infections, central nervous system infections, and intra-abdominal infections (2).S. lugdunensis has a lower incidence than Staphylococcus aureus and Staphylococcus epidermidis (3-5). Many studies have focused on cases of bacteremia and endocarditis caused by S. lugdunensis and have shown that this bacterium can, like S. aureus, cause invasive infections but with higher rates of complications and mortality (4, 6-10). Endocarditis due to this bacterium has been reported to be mostly community associated (CA) (4, 7). Two retrospective studies showed that most CA S. lugdunensis infections were skin and soft tissue infections, with a total absence of oxacillin resistance (11, 12). We recently reported 48 cases of invasive S. lugdunensis infection. Most of these cases (43 of 48 [89.6%]) were health care-associated (HA) infections, and the frequency ...

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Section: Discussionmentioning

confidence: 97%

Clinical Features, Outcomes, and Molecular Characteristics of Community- and Health Care-Associated Staphylococcus lugdunensis Infections

et al. 2016

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“…S. aureus strains were used as positive controls: Mu50 (SCCmec II) [17], 63a (SCCmec III) [18], and 526a (SCCmec IV and pvlpositive) [19]. S. lugdunensis strain (468s) was used as positive control of SCCmec V [20].…”

Section: Detection Of Pvl and Meca Genes And Sccmec Typingmentioning

confidence: 99%

High rate of neonates colonized by methicillin-resistant Staphylococcus species in an Intensive Care Unit

Salgueiro

Seixas

Guimarães

et al. 2019

J Infect Dev Ctries

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Introduction: Staphylococcal colonization is a risk factor for healthcare-associated infections, which are frequent in Neonatal Intensive Care Units (NICU). This study analyzed microbiology, epidemiology and clinical aspects of Staphylococcus spp. colonizing neonates. Methodology: Nasal or periumbilical swabs were evaluated from 175 newborns admitted to a NICU of a Rio de Janeiro hospital from March to September 2009. Clinical data were obtained from the medical records. SCCmec typing and the mecA and Panton-Valentine Leukocidin (PVL) genes were detected by PCR. Clonal diversity was evaluated by pulsed-field gel electrophoresis. Results: Staphylococcus spp. isolates were detected in 98 (56%) neonates, 66.3% of them had birth weight ≤ 2500 g, 62.2% were preterm (˂ 37 weeks) and the mean length of hospitalization was 14.9 days. Among the 133 isolates identified, 48.1% were S. epidermidis, 23.3% S. haemolyticus and 13.5% S. aureus. Methicillin-resistant Staphylococcus isolate was detected in 77.6% of neonates. The methicillin-resistant S. aureus isolates carried the SCCmec type IV, while 94.6% of S. epidermidis and 85.7% of S. haemolyticus presented non-typeable cassettes. Among the S. aureus, 55.6% had PVL genes and the USA800 genotype was prevalent. Two genotypes of S. epidermidis and one of S. haemolyticus clustered 42.2% and 25.8% of the isolates, respectively. S haemolyticus colonization was associated with the use of parenteral nutrition and mechanical ventilation. Conclusion: High rate of neonates colonized by methicillin-resistant Staphylococcus species and the permanence of clones circulating in the NICU highlight the importance for continuous and preventive surveillance in this high-risk population.

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“…In a literature review, Seenivasan and Yu (25) described that perineal skin flora appeared to be the source of the organism in patients with S. lugdunensis endocarditis. Moreover, the aggressive nature of S. lugdunensis resembles S. aureus (24). Thus, we speculated that the mode of transmission of S. lugdunensis infection observed in the present case was from the skin, although there was no direct evidence to support this.…”

Section: Discussionmentioning

confidence: 64%

“…In the present case, the risk of serious infection such as endocarditis or recurrent sepsis should continue to be considered as her cardiac shunt still persists. Since she had no skin lesions and did not undergo a catheter examination or catheter therapy (22,24), the infectious route of S. lugdunensis that induced sepsis in this case was unclear. In a literature review, Seenivasan and Yu (25) described that perineal skin flora appeared to be the source of the organism in patients with S. lugdunensis endocarditis.…”

Section: Discussionmentioning

confidence: 95%

Successful Treatment of Sepsis Caused by Staphylococcus lugdunensis in an Adult with 22q11.2 Deletion Syndrome

et al. 2012

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A 27-year-old woman visited our hospital because of high fever. She had been diagnosed as 22q11.2 deletion syndrome (22q11.2DS) due to her cardiac history (tetralogy of Fallot), thymic hypoplasia and 22q11.2 deletion. She had a normal CD4/CD8 ratio, a slightly decreased lymphocyte count and normal serum immunoglobulin levels. Blood cultures were positive for Staphylococcus lugdunensis (S. lugdunensis). Infection route of S. lugdunensis in this case was unclear. The patient was successfully treated with several intravenous antibiotics. Infection should be considered when managing patients with 22q.11.2DS. regardless of whether their immune system is impaired.

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Methicillin-resistant Staphylococcus lugdunensis carrying SCCmec type V misidentified as MRSA

Cited by 4 publications

References 8 publications

Clinical Features, Outcomes, and Molecular Characteristics of Community- and Health Care-Associated Staphylococcus lugdunensis Infections

Clinical Features, Outcomes, and Molecular Characteristics of Community- and Health Care-Associated Staphylococcus lugdunensis Infections

High rate of neonates colonized by methicillin-resistant Staphylococcus species in an Intensive Care Unit

Successful Treatment of Sepsis Caused by Staphylococcus lugdunensis in an Adult with 22q11.2 Deletion Syndrome

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