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Staphylococcus lugdunensis Endocarditis: Lower Mortality in the Contemporary Era?
Benjamin T Leis1, Dwip D Parekh2, Brendon F Macknak2
1Division of General Internal Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
CJC Open
|May 24, 2022
Summary
Staphylococcus lugdunensis infective endocarditis (IE) in Saskatchewan showed lower mortality and surgical intervention rates than previously reported. This study examined IE cases in a population with injection drug use (IDU), finding similarities and differences in clinical presentation and outcomes.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Staphylococcus lugdunensis is a virulent coagulase-negative Staphylococcus species.
- Infective endocarditis (IE) caused by S. lugdunensis is rare but associated with high mortality.
- Saskatchewan has seen rising IE rates, with overlapping epidemics of HIV/hepatitis C virus linked to injection drug use (IDU).
Purpose of the Study:
- To investigate S. lugdunensis IE cases in Saskatchewan.
- To compare findings with existing literature, considering the local population's challenges with IDU and healthcare access.
- To analyze baseline characteristics, antimicrobial susceptibility, management, and outcomes of S. lugdunensis IE.
Main Methods:
- Retrospective review of S. lugdunensis endocarditis cases admitted to tertiary care hospitals in Saskatoon over a 6-year period.
- Analysis of patient baseline characteristics, antimicrobial susceptibility, management, and outcomes.
- Application of the modified Duke's criteria to verify definite and probable IE cases.
Main Results:
- Six cases of definite IE and two of probable IE were identified from 24 positive blood cultures.
- Native valves were involved in 5 of 8 cases; 5 cases involved left-sided valves.
- Only one death was recorded, with a lower rate of surgical intervention than previously observed.
Conclusions:
- S. lugdunensis IE in this cohort showed male predominance and left-sided valve involvement, consistent with literature.
- Lower surgical intervention and mortality rates were observed, warranting further investigation.
- Coinfection with HIV/hepatitis C virus was not identified as a risk factor, potentially due to a low rate of IDU in the study population.
