[Joint prosthesis infection with Staphyococcus lugdunensis: 7 cases]

Area of Science:

• Microbiology
• Infectious Diseases
• Orthopedic Surgery

Background:

• Staphylococcus lugdunensis, a coagulase-negative staphylococcus, causes severe infections, particularly in cardiology.
• While S. lugdunensis exhibits virulence factors and strong adherence, it remains sensitive to antibiotics.
• Publications on S. lugdunensis joint prosthesis infections are scarce, often reporting treatment failures without prosthesis removal.

Observation:

• Seven cases of S. lugdunensis joint prosthesis infections between 1991 and 2005 were analyzed.
• Four chronic infections were successfully managed with a two-stage (implant removal then reimplantation) or single-stage procedure combined with antibiotics.
• Three cases failed treatment, including two likely hematogenous infections and one early postoperative infection, despite lavage and antibiotics.

Findings:

• The classical approach of implant removal and reimplantation (two-stage or single-stage) is effective for chronic S. lugdunensis joint prosthesis infections.
• Early lavage and antibiotic therapy without prosthesis removal were unsuccessful in treating S. lugdunensis joint prosthesis infections.
• S. lugdunensis demonstrates significant adherence and virulence, contributing to the severity of joint prosthesis infections.

Implications:

• Surgical intervention involving prosthesis removal and reimplantation is crucial for managing S. lugdunensis joint prosthesis infections.
• Further research is needed to understand the specific virulence factors of S. lugdunensis in orthopedic infections.
• This study highlights the importance of considering S. lugdunensis in the differential diagnosis of prosthetic joint infections and tailoring treatment strategies accordingly.