Staphylococcus lugdunensis Infective Endocarditis: A Literature Review and Analysis of Risk Factors

Liu, Po Yen; Huang, Yung Feng; Tang, Chia Wan; Chen, Ying Yao; Hsieh, Kai‐Sheng; Ger, Luo Ping; Chen, Yao Shen; Liu, Yung Ching

doi:10.1016/s1684-1182(10)60074-6

Cited by 87 publications

(99 citation statements)

References 39 publications

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“…Such associations of S. lugdunensis with severe infections were previously reported in various patient cases and series, including specimens from various origins, i.e. endocarditis, skin and soft tissue infections, arthritis, prosthetic joint infections, sepsis without identified gateway, pseudo-toxic shock syndrome, necrotizing sinusitis, and brain abscesses (30)(31)(32)(33)(34)(35). S. lugdunensis is the second cause of endocarditis due to CoNS, with a poor prognosis in 40% of cases (36).…”

Section: Discussionmentioning

confidence: 55%

Implementation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Routine Clinical Laboratories Improves Identification of Coagulase-Negative Staphylococci and Reveals the Pathogenic Role of Staphylococcus lugdunensis

et al. 2015

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The use of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for staphylococcal identification is now considered routine in laboratories compared with the conventional phenotypical methods previously used. We verified its microbiological relevance for identifying the main species of coagulase-negative staphylococci (CoNS) by randomly selecting 50 isolates. From 1 January 2007 to 31 August 2008, 12,479 staphylococci were isolated with phenotypic methods, of which 4,594 were identified as Staphylococcus aureus and 7,885 were coagulase negative staphylococci. Using MALDI-TOF MS from 1 January 2011 to 31 August 2012, 14,913 staphylococci were identified, with 5,066 as S. aureus and 9,847 as CoNS. MALDI-TOF MS allowed the identification of approximately 85% of the CoNS strains, whereas only 14% of the CoNS strains were identified to the species level with phenotypic methods because they were often considered contaminants. Furthermore, the use of MALDI-TOF MS revealed the occurrence of recently characterized Staphylococcus species, such as S. pettenkoferi, S. condimenti, and S. piscifermentans. Microbiological relevance analysis further revealed that some species displayed a high rate of microbiological significance, i.e., 40% of the S. lugdunensis strains included in the analysis were associated with infection risk. This retrospective microbiological study confirms the role of MALDI-TOF MS in clinical settings for the identification of staphylococci with clinical consequences. The species distribution reveals the occurrence of the recently identified species S. pettenkoferi and putative virulent species, including S. lugdunensis. C oagulase-negative staphylococci (CoNS) are normal inhabitants of the human skin that lately have revealed themselves as significant etiological agents causing nosocomial infections, particularly in medical devices (1-4). Until recently, the phenotypic identification of Ͼ40 currently recognized CoNS species remained a challenge, because the technique was labor-intensive and uncommon CoNS were usually not identified (5, 6). Until recently, CoNS identification at the species level was performed only for clinical isolates that were considered clinically significant according to clinical or microbiological criteria. Meanwhile, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has emerged as a reliable, fast, and cost-effective alternative for bacterial species identification and is now widely used in microbiology laboratories (7,8). This method allows the identification of all staphylococci isolated in the clinical setting, thus rendering the use of well-known tests, such as free or bound coagulase tests, unnecessary. Previous reports have shown that MALDI-TOF MS is a reliable method to identify Staphylococcus at the species level; however, questions regarding the impact of such methods in clinical settings remain uncertain (9). Staphylococcus epidermidis is probably the major CoNS species causing nosocomial inf...

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Section: Discussionmentioning

confidence: 55%

Implementation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Routine Clinical Laboratories Improves Identification of Coagulase-Negative Staphylococci and Reveals the Pathogenic Role of Staphylococcus lugdunensis

et al. 2015

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“…Staphylococcus lugdunensis, a member of coagulase-negative staphylococci (CoNS) first described in 1988 by Freney et al (5a), often causes skin and soft tissue infections; severe infections attributed to this organism are not rare (1,8). Its clinical course and microbiological characteristics may resemble those of the coagulase-positive Staphylococcus aureus (4,6) and has been associated with more invasive infections (2,4,8,11,13).…”

mentioning

confidence: 99%

Clinical and Microbiological Characteristics of Community-Acquired Staphylococcus lugdunensis Infections in Southern Taiwan

Wang

Tseng

et al. 2011

J Clin Microbiol

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Most Staphylococcus lugdunensis strains (49/59, 83%) were related to clinical infections, were susceptible to most antimicrobial agents with an overall oxacillin-resistant rate of 5% (3/58), and carried relatively great genetic diversity. Community-acquired infections (41/49, 84%) were dominant, often developed in patients with comorbidity, and had rather benign clinical courses without mortality.

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“…In addition, the isolate showed negative results for the slide and tube coagulase tests (performed with EDTAhuman plasma) with the primary and subculturing cultures. In the tube coagulase test, the isolate tested negative at every time point (1,2,3,4,6,8,10,12, and 24 h). Staphylococcus aureus (ATCC 25923) was used as the positive control.…”

mentioning

confidence: 99%

“…Infections caused by this bacterium include acute postoperative endophthalmitis (6), acute necrotizing sinusitis (7), prosthetic joint infections (8), urinary tract infections (9), and skin and soft tissue infections (4). Most importantly, S. lugdunensis has been associated with native valve endocarditis, an aggressive infection that is associated with a high mortality risk (2,10 (11,12). To date, Staphylococcus aureus subsp.…”

mentioning

confidence: 99%

Catalase-Negative Staphylococcus lugdunensis Strain with a Novel Point Mutation in the Catalase Gene Isolated from a Patient with Chronic Suppurative Otitis Media

Lu¹,

Wang²,

Ling

et al. 2013

J Clin Microbiol

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dThis report describes the results of the sequence analysis of a methicillin-susceptible strain of catalase-negative Staphylococcus lugdunensis. Molecular characterization of the deduced sequence revealed a novel point mutation in the catalase gene. To our knowledge, this is the first report of a catalase-negative S. lugdunensis strain, although catalase-negative isolates of Staphylococcus aureus and Staphylococcus epidermidis have been previously reported. CASE REPORTA 22-year-old woman presented to the Department of Otolaryngology with chronic suppurative otitis media. A pus sample was collected from her ear canal for routine microbial cultivation. The sample was inoculated in sheep blood agar and chocolate agar and incubated anaerobically and aerobically at 37°C for 24 h. After incubation, 1-to 2-mm creamy white colonies without hemolytic reaction were detected on sheep blood agar and chocolate agar plates maintained under aerobic atmospheric conditions. The bacterium was found to be catalase negative on analysis with 3% H 2 O 2 , and Gram staining showed the presence of Gram-positive staphylococcal clusters. The bacterium was again tested for the next 2 generations for catalase activity after subculturing on sheep blood agar and chocolate agar; the results remained negative for each generation. In addition, the isolate showed negative results for the slide and tube coagulase tests (performed with EDTAhuman plasma) with the primary and subculturing cultures.

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Staphylococcus lugdunensis Infective Endocarditis: A Literature Review and Analysis of Risk Factors

Abstract: S. lugdunensis endocarditis led to substantial morbidity and mortality. Detailed microbiological identification, echocardiography evaluation, and valve replacement may improve the clinical outcome of individuals with S. lugdunensis endocarditis.

Cited by 87 publications

References 39 publications

Implementation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Routine Clinical Laboratories Improves Identification of Coagulase-Negative Staphylococci and Reveals the Pathogenic Role of Staphylococcus lugdunensis

Implementation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Routine Clinical Laboratories Improves Identification of Coagulase-Negative Staphylococci and Reveals the Pathogenic Role of Staphylococcus lugdunensis

Clinical and Microbiological Characteristics of Community-Acquired Staphylococcus lugdunensis Infections in Southern Taiwan

Catalase-Negative Staphylococcus lugdunensis Strain with a Novel Point Mutation in the Catalase Gene Isolated from a Patient with Chronic Suppurative Otitis Media

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