Staphylococcus Lugdunensis Native Tricuspid Valve Endocarditis: a Case Report and Review of Literature

Abstract

Coagulase negative staphylococci are skin commensals and are generally disregarded as contaminants in clinical specimens. Repeated isolation of coagulase negative staphylococci in blood cultures should warrant a species identification to recognize unusually virulent organisms that demand aggressive treatment, such as Staphylococcus lugdunensis. Staphylococcus lugdunensis is known to cause a wide variety of infections, including a predominant left-sided endocarditis. We report a rare case of native tricuspid valve Staphylococcus lugdunensis endocarditis in a non-intravenous drug user and include a brief literature review.KEY WORDS: Staphylococcus lugdunensis; coagulase negative staphylococci; skin commensals; left-sided endocarditis.

Catalase-Negative Staphylococcus lugdunensis Strain with a Novel Point Mutation in the Catalase Gene Isolated from a Patient with Chronic Suppurative Otitis Media

“…In addition, the isolate showed negative results for the slide and tube coagulase tests (performed with EDTAhuman plasma) with the primary and subculturing cultures. In the tube coagulase test, the isolate tested negative at every time point (1,2,3,4,6,8,10,12, and 24 h). Staphylococcus aureus (ATCC 25923) was used as the positive control.…”

“…Positive results were obtained with the ornithine decarboxylase (ODC) and pyrrolidonyl arylamidase (PYR) (bioMérieux) tests. S. lugdunensis could be differentiated from other coagulase-negative staphylococci on the basis of its ability to produce ODC and PYR (2). Antibiotic susceptibility was determined using the Vitek 2 AST-GP67 card, and the strain was found to be susceptible to ampicillin, ciprofloxacin, clindamycin, erythromycin, gentamicin, levofloxacin, linezolid, moxifloxacin, nitrofurantoin, oxacillin, quinupristin-dalfopristin, rifampin, tetracycline, tigecycline, trimethoprim-sulfamethoxazole, and vancomycin but not penicillin.…”

“…Infections caused by this bacterium include acute postoperative endophthalmitis (6), acute necrotizing sinusitis (7), prosthetic joint infections (8), urinary tract infections (9), and skin and soft tissue infections (4). Most importantly, S. lugdunensis has been associated with native valve endocarditis, an aggressive infection that is associated with a high mortality risk (2,10 (11,12). To date, Staphylococcus aureus subsp.…”

Staphylococcus lugdunensis endocarditis with destruction of the ventricular septum and multiple native valves

“…It has been reported as a cause of destructive infective endocarditis with large vegetations visualized on echocardiography and the destruction of the native valves as can occur with S. aureus [10]. It mostly cause left sided infective endocarditis [11], although tricuspid valve involvement has been reported [11], [12].…”

The phage integrase vector pIPI03 allows RecA -independent, site-specific labelling of Staphylococcus lugdunensis strains

“…The species is a commensal of human skin that is predominantly isolated of the moist areas such as perineum and the inguinal fold (Bieber and Kahlmeter, 2010). However it is particularly associated with cases of infective endocarditis (Anguera et al, 2005;Patil et al, 2011;Vandenesch et al, 1993) with a course of disease akin to Staphylococcus aureus infections. Although S. lugdunensis is recognized to be an important pathogen, remarkably little is known about virulence factors and the molecular mechanisms of pathogenicty.…”