Staphylococcus lugdunensis in several niches of the normal skin flora

Abstract

Staphylococcus lugdunensis is a coagulase-negative staphylococcus (CNS). Its pathogenicity and virulence are more similar to Staphylococcus aureus than to a CNS. It causes severe infections with high mortality, such as endocarditis, but more often painful and prolonged skin- and soft-tissue infections. Little is known of its normal habitat. Whether it is an integral part of the normal skin flora like many other CNS has been questioned, since it is rarely seen in blood cultures. This study was designed to determine whether S. lugdunensis has a niche in the normal skin flora and to compare S. lugdunensis and S. aureus in these niches.From 75 healthy subjects in Kronoberg County, Sweden, 525 swabs were obtained from the nose, axilla, perineum, groin, breast, toe and nail bed of the first toe. Significantly more of the 525 skin samples as well as of the 75 healthy subjects yielded S. lugdunensis (50/75) as opposed to S. aureus.(16/75). Swabs from the nose frequently yielded S. aureus, but only rarely S. lugdunensis. Swabs from the groin and the lower extremities, especially the nail bed of the first toe, often yielded S. lugdunensis but rarely S. aureus. This study shows that S. lugdunensis is an integral part of the normal skin flora, primarily of the lower abdomen and extremities, and that the niches of this coagulase-negative staphylococcus are distinctly different from those of S. aureus. The predominant niches of S. lugdunensis explain why the bacterium is an uncommon contaminant of blood cultures.

Acute Necrotizing Sinusitis Caused by Staphylococcus lugdunensis

“…S. lugdunensis has also been reported as a cause of skin and soft tissue infections, particularly involving the breast, abdomen, and lower limbs (1,2,4), and has been identified as an agent of prosthetic joint infection (10). In keeping with these reports, studies that have screened healthy persons for carriage have confirmed identification from skin of the abdomen, groin, and lower extremities (3,12).…”

Staphylococcus lugdunensis: case report and discussion

“…This study demonstrates that, although they are both integral skin flora, S. lugdunensis and S. aureus differ in their site and frequency of colonisation. 12 The clinical relevance of S. lugdunensis was first described when it was implicated as a causative organism in endocarditis. 13 Since this time more than 80 further case reports of S. lugdunensis endocarditis have been reported, primarily involving native left-sided valves.…”

Multilocus Sequence Typing Analysis of Staphylococcus lugdunensis Implies a Clonal Population Structure

“…S. lugdunensis is recovered from the normal skin flora (1), and numerous infections have been related to inguinal-area carriage (37). Cutaneous infections account for more than 50% of S. lugdunensis infections (38), but tissue infections with various abscess localizations are reported, with tissue damage or poor clinical outcome (13).…”