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[Soft tissue infections with S. Lugdunensis. Presentation of 2 cases and general review]
1Servicio de Enfermedades Infecciosas, Hospital del Aire, Universidad Complutense, Madrid.
Abstract:
Staphylococcus lugdunensis was first described in 1988 by Freney et al. Since that moment, it has been recognised as an important cause of endocarditis that is able to involve native valves and follow an aggressive, often fatal course. By now, we know only few potential virulence factors, but its ability to produce a wide range of human infections, varying from life threatening (such us endocarditis) to more benign ones, is unquestionable. Unlike other coagulase negative Staphylococci, S. lugdunensis is frequently implicated in soft tissue infections and affects commonly persons with clinical antecedents of neoplastic diseases. We report two new cases of deep tissue abscesses in patients that had history of uterine tumours. In both occasions we isolated coagulase negative Staphylococci that were markedly susceptible to all the antimicrobial agents tested. It is relevant to perform a detailed microbiological study in order to avoid misidentification of this species, since it differs significantly from other coagulase negative ones and may lead to important morbidity--and even mortality--. There are great differences in the rates of resistant strains between countries and, up-to-date, the lack of antibiotics susceptibility seems not to be a serious problem in Europe if we compare with the 30% american strains that are resistant via production of beta-lactamase.
Insights
Staphylococcus lugdunensis causes severe infections like endocarditis and soft tissue abscesses, particularly in cancer patients. Prompt identification is crucial to prevent serious outcomes and ensure appropriate treatment.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Bacteriology
Background:
- Staphylococcus lugdunensis, first described in 1988, is a significant pathogen.
- It is known to cause aggressive and potentially fatal endocarditis, often involving native valves.
- Virulence factors are not fully understood, but its capacity to cause diverse infections is established.
Observation:
- S. lugdunensis differs from other coagulase-negative staphylococci.
- It is frequently associated with soft tissue infections.
- Patients with a history of neoplastic diseases are commonly affected.
- Two cases of deep tissue abscesses in patients with uterine tumors are presented.
Findings:
- The isolated S. lugdunensis strains showed marked susceptibility to tested antimicrobial agents.
- Accurate microbiological identification is essential due to significant differences from other coagulase-negative staphylococci.
- Antibiotic resistance is a concern, with 30% of American strains resistant due to beta-lactamase production, contrasting with lower rates in Europe.
Implications:
- Misidentification of S. lugdunensis can lead to significant patient morbidity and mortality.
- Understanding S. lugdunensis epidemiology and resistance patterns is vital for effective clinical management.
- Further research into S. lugdunensis virulence and resistance mechanisms is warranted.