Staphylococcus lugdunensis infective endocarditis: a multicentre international observational study

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Staphylococcus lugdunensis (SL) is an emerging cause of infective endocarditis (IE) with significant complication and mortality rates.
• The 2023 Duke-ISCVID criteria recognize SL blood cultures as a major microbiological criterion for IE diagnosis.
• Understanding the contemporary profile of SLIE is crucial for clinical management and risk stratification.

Purpose of the Study:

• To characterize the current clinical features of Staphylococcus lugdunensis infective endocarditis (SLIE).
• To identify factors associated with in-hospital mortality in patients with SLIE.
• To compare SLIE characteristics with those of Staphylococcus aureus IE.

Main Methods:

• A collaborative international multicenter study involving 17 centers across Europe and Brazil.
• Inclusion of 112 patients diagnosed with definite SLIE between 2010 and 2024.
• Data collection on patient demographics, clinical presentation, microbiological findings, treatment, and outcomes, including in-hospital mortality.

Main Results:

• The study included 112 patients with a mean age of 67 years; 67.9% were male.
• Common complications included emboli (50%), heart failure (32%), and acute kidney injury (39.4%). Perivalvular abscesses occurred in 20.5% of cases.
• In-hospital mortality was 29.5%. Independent predictors of mortality were advanced age, malignancy, severe mitral regurgitation, paravalvular abscess, and high-degree atrioventricular block. All SL isolates were methicillin-susceptible.

Conclusions:

• SLIE exhibits aggressiveness, healthcare-associated acquisition patterns, and high mortality rates comparable to Staphylococcus aureus IE.
• The susceptibility of all studied SL isolates to methicillin is a notable finding.
• Early identification of risk factors and prompt management are essential for improving outcomes in SLIE patients.