Staphylococcus lugdunensis Endocarditis: A Complication of Vasectomy?

Fervenza, Fernando C.; Contreras, Gail E.; Garratt, Kirk N.; Steckelberg, James M.

doi:10.4065/74.12.1227

Cited by 39 publications

(27 citation statements)

References 23 publications

(4 reference statements)

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“…This organism is uniformly susceptible in vitro to most antibiotics. [83][84][85][86][87][88][89] Most experts recommend that endocarditis caused by this organism be treated with standard regimens based on the in vitro susceptibility profiles of the strain. The patient also should be monitored carefully for the development of periannular extension or extracardiac spread of infection.…”

Section: Coagulase-negative Staphylococcimentioning

confidence: 99%

Infective Endocarditis

Baddour¹,

Wilson²,

Bayer³

et al. 2005

Circulation

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1,276

436

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Background-Despite advances in medical, surgical, and critical care interventions, infective endocarditis remains a disease that is associated with considerable morbidity and mortality. The continuing evolution of antimicrobial resistance among common pathogens that cause infective endocarditis creates additional therapeutic issues for physicians to manage in this potentially life-threatening illness. Methods and Results-This work represents the third iteration of an infective endocarditis "treatment" document developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It updates recommendations for diagnosis, treatment, and management of complications of infective endocarditis. A multidisciplinary committee of experts drafted this document to assist physicians in the evolving care of patients with infective endocarditis in the new millennium. This extensive document is accompanied by an executive summary that covers the key points of the diagnosis, antimicrobial therapy, and management of infective endocarditis. For the first time, an evidence-based scoring system that is used by the American College of Cardiology and the American Heart Association was applied to treatment recommendations. Tables also have been included that provide input on the use of echocardiography during diagnosis and treatment of infective endocarditis, evaluation and treatment of culture-negative endocarditis, and short-term and long-term management of patients during and after completion of antimicrobial treatment. To assist physicians who care for children, pediatric dosing was added to each treatment regimen. Conclusions-The recommendations outlined in this update should assist physicians in all aspects of patient care in the diagnosis, medical and surgical treatment, and follow-up of infective endocarditis, as well as management of associated complications. Clinical variability and complexity in infective endocarditis, however, dictate that these guidelines be used to support and not supplant physician-directed decisions in individual patient management. (Circulation. 2005; 111:e394-e433.)

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Section: Coagulase-negative Staphylococcimentioning

confidence: 99%

Infective Endocarditis

Baddour¹,

Wilson²,

Bayer³

et al. 2005

Circulation

Self Cite

1,276

436

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“…There have been five reports of S. lugdunensis native valve endocarditis that developed 1 to 3 months following vasectomy in men ranging in age from 32 to 45 years (58,104,195). Significant valve damage occurred in all cases.…”

Section: Endocarditismentioning

confidence: 99%

From Clinical Microbiology to Infection Pathogenesis: How Daring To Be Different Works forStaphylococcus lugdunensis

2008

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SUMMARY Staphylococcus lugdunensis has gained recognition as an atypically virulent pathogen with a unique microbiological and clinical profile. S. lugdunensis is coagulase negative due to the lack of production of secreted coagulase, but a membrane-bound form of the enzyme present in some isolates can result in misidentification of the organism as Staphylococcus aureus in the clinical microbiology laboratory. S. lugdunensis is a skin commensal and an infrequent pathogen compared to S. aureus and S. epidermidis, but clinically, infections caused by this organism resemble those caused by S. aureus rather than those caused by other coagulase-negative staphylococci. S. lugdunensis can cause acute and highly destructive cases of native valve endocarditis that often require surgical treatment in addition to antimicrobial therapy. Other types of S. lugdunensis infections include abscess and wound infection, urinary tract infection, and infection of intravascular catheters and other implanted medical devices. S. lugdunensis is generally susceptible to antimicrobial agents and shares CLSI antimicrobial susceptibility breakpoints with S. aureus. Virulence factors contributing to this organism's heightened pathogenicity remain largely unknown. Those characterized to date suggest that the organism has the ability to bind to and interact with host cells and to form biofilms on host tissues or prosthetic surfaces.

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“…Patel et al (24) found that S. lugdunensis accounted for 18% of CoNS strains causing infective endocarditis and 44% of CoNS strains causing native valve endocarditis. The mortality rate as a result of endocarditis caused by S. lugdunensis is high (7,15,31). Few studies have looked at the epidemiology and ecology of S. lugdunensis.…”

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confidence: 99%

Staphylococcus lugdunensis Infections: High Frequency of Inguinal Area Carriage

et al. 2003

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Following a change in surgical practice, we noted that the rate at which Staphylococcus lugdunensis was isolated from samples from the plastic surgery unit of our hospital increased considerably. We investigated the sources of these S. lugdunensis strains, and we found that in the case of drain colonization or surgical site infection, the strain was more likely to have come from the patient's skin bacteria when the pubic site had been shaved preoperatively. To test the hypothesis of pubic site colonization, we evaluated the prevalence of S. lugdunensis carriage among the cutaneous flora of the inguinal area. We found that 22% of 140 incoming patients carried S. lugdunensis in this area and that carriage at both inguinal folds was frequent (68% of carriers). A study of the genetic structure of the total population, including the clinical (n ‫؍‬ 18) and the commensal (n ‫؍‬ 53) strains, revealed that the diversity of the species was low and that the population was composed of two major groups that diverged at a distance of 35%. No particular characteristics made it possible to distinguish between clinical and commensal strains. Only isolates producing ␤-lactamase were homogeneous; six of the eight ␤-lactamase-positive strains displayed the same pulsed-field gel electrophoresis pattern.Staphylococcus lugdunensis is a coagulase-negative Staphylococcus (CoNS) that was first described by Freney et al. (9) in 1988 and that has the potential to be an opportunistic pathogen. S. lugdunensis is an unusually virulent CoNS and can cause many types of infection, ranging from superficial skin infections to life-threatening endocarditis. Most laboratory isolates are collected from colonized patients or patients with primary skin infections or minor postoperative wound infections. Nevertheless, S. lugdunensis has been shown to be associated with serious infections such as breast abscesses (18, 34), peritonitis (19, 28), infected joint prostheses (26, 35), osteomyelitis (22), discitis (2), septic arthritis (12), and pacemaker infections (1,3,16). Unlike S. epidermidis, which usually results in indolent subacute infections, S. lugdunensis results in acute infections, similar to S. aureus. S. lugdunensis infections typically resemble S. aureus infections in terms of the virulence of the organism and the clinical course of infection, which is often highly destructive (28, 31, 33).S. lugdunensis can act as an etiologic agent of infective endocarditis. It may infect both prosthetic and native valves (31). Patel et al. (24) found that S. lugdunensis accounted for 18% of CoNS strains causing infective endocarditis and 44% of CoNS strains causing native valve endocarditis. The mortality rate as a result of endocarditis caused by S. lugdunensis is high (7,15,31). Few studies have looked at the epidemiology and ecology of S. lugdunensis. Similar to other CoNS strains, S. lugdunensis is considered part of the resident flora of the entire surface of the human skin and mucous membranes (11). No detailed studies have been carried out on the d...

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Staphylococcus lugdunensis Endocarditis: A Complication of Vasectomy?

Cited by 39 publications

References 23 publications

Infective Endocarditis

Infective Endocarditis

From Clinical Microbiology to Infection Pathogenesis: How Daring To Be Different Works forStaphylococcus lugdunensis

Staphylococcus lugdunensis Infections: High Frequency of Inguinal Area Carriage

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