The “surreptitious staphylococcus”staphylococcus lugdunensis endocarditis in a child

Sotutu, Viliame; Carapetis, Jonathan R.; Wilkinson, James D.; Davis, Andrew M.; Curtis, Nigel

doi:10.1097/00006454-200210000-00023

Cited by 29 publications

(19 citation statements)

References 22 publications

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“…Since that time, S. lugdunensis, named after Lyon, France, the city where the organism was initially isolated (68), has emerged as an important human pathogen with notable clinical and microbiological characteristics that stand out among those of other CNS. Described previously as "surreptitious" (171) and a "wolf in sheep's clothing," S. lugdunensis behaves more like S. aureus than other CNS in many respects, including exhibiting an elevated degree of virulence. S. lugdunensis is both a skin commensal and a pathogen responsible for nosocomial and community-acquired infections that may proceed aggressively and with a level of severity reminiscent of that of S. aureus infections.…”

Section: Introductionmentioning

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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Section: Introductionmentioning

confidence: 99%

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

2008

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“…Emerging as an important human pathogen, S. lugdunensis has an elevated level of virulence that makes it stand out among the CNS (15,33). Unlike other CNS, S. lugdunensis can cause a wide array of serious infections, such as acute endocarditis, brain abscesses, meningitis, prosthetic joint infections, pneumonia, and toxic shock (15).…”

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Staphylococcus lugdunensis IsdG Liberates Iron from Host Heme

et al. 2011

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Staphylococcus lugdunensis is often found as part of the normal flora of human skin but has the potential to cause serious infections even in healthy individuals. It remains unclear what factors enable S. lugdunensis to transition from a skin commensal to an invasive pathogen. Analysis of the complete genome reveals a putative iron-regulated surface determinant (Isd) system encoded within S. lugdunensis. In other bacteria, the Isd system permits the utilization of host heme as a source of nutrient iron to facilitate bacterial growth during infection. In this study, we establish that S. lugdunensis expresses an ironregulated IsdG-family heme oxygenase that binds and degrades heme. Heme degradation by IsdG results in the release of free iron and the production of the chromophore staphylobilin. IsdG-mediated heme catabolism enables the use of heme as a sole source of iron, establishing IsdG as a pathophysiologically relevant heme oxygenase in S. lugdunensis. Together these findings offer insight into how S. lugdunensis fulfills its nutritional requirements while invading host tissues and establish the S. lugdunensis Isd system as being involved in heme-iron utilization.

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“…It causes severe infections similar to Staphylococcus aureus infections, especially acute endocarditis in prosthetic and native valves (14,24,29,30,36). Other infections such as osteomyelitis (17,23), peritonitis (28), intravascular catheter infections (5,32), prosthetic joint infections (26), and urinary tract infections have also been reported (10).…”

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Staphylococcus lugdunensis , a Common Cause of Skin and Soft Tissue Infections in the Community

et al. 2009

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Staphylococcus lugdunensis, a rare cause of severe infections such as native valve endocarditis, often causes superficial skin infections similar to Staphylococcus aureus infections. We initiated a study to optimize the identification methods in the routine laboratory, followed by a population-based epidemiologic analysis of patients infected with S. lugdunensis in Viborg County, Denmark. Recognition of a characteristic Eikenella corrodens-like odor on Columbia sheep blood agar combined with colony pleomorphism and prominent ␤-hemolysis after 2 days of incubation, confirmed by API-ID-32 Staph, led to an 11-fold increase in the detection of S. lugdunensis. By these methods we found 491 S. lugdunensis infections in 4 years, corresponding to an incidence of 53 per 100,000 per year, an increase from 5 infections per 100,000 inhabitants in the preceding years. Seventy-five percent of the cases were found in general practice; these were dominated by skin abscesses (36%), wound infections (25%), and paronychias (13%). Fifty-six percent of the infections occurred below the waist, and toes were the most frequently infected site (21%). Only 3% of the patients suffered from severe invasive infections. The median age was 52 years, and the male/female ratio was 0.69. Our study shows that S. lugdunensis is a common cause of skin and soft-tissue infections (SSTI) and is probably underrated by many laboratories. S. lugdunensis should be accepted as a significant pathogen in SSTI and should be looked for in all routine bacteriological examinations, and clinicians should be acquainted with the name and the pathology of the bacterium.Staphylococcus lugdunensis, one of the coagulase-negative staphylococci (CoNS), was first described by Freney et al. 20 years ago (8). It causes severe infections similar to Staphylococcus aureus infections, especially acute endocarditis in prosthetic and native valves (14,24,29,30,36). Other infections such as osteomyelitis (17, 23), peritonitis (28), intravascular catheter infections (5, 32), prosthetic joint infections (26), and urinary tract infections have also been reported (10). S. lugdunensis has been reported as an important cause also of skin and soft tissue infections (SSTI), primarily in the groin (1, 39) and mammae (13,22,25,37,41).S. lugdunensis is part of the normal human skin flora and commonly colonizes the perineal region (1, 37, 39); however, carriage rates of different CoNS are not comprehensively accounted for, and only a few have looked for S. lugdunensis carriage (13, 16, 39).Our study was undertaken after two serious cases of S. lugdunensis infection, a fatal case of endocarditis with protracted bacterial identification but correct antibiotic treatment and a case of late-diagnosed osteomyelitis, which prompted an optimization of our routine microbiological methods for identification of S. lugdunensis. This subsequently increased the number of S. lugdunensis isolates significantly, especially in samples from patients in general practice, and encouraged us to conduct a prospectiv...

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The “surreptitious staphylococcus”staphylococcus lugdunensis endocarditis in a child

Cited by 29 publications

References 22 publications

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

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

Staphylococcus lugdunensis IsdG Liberates Iron from Host Heme

Staphylococcus lugdunensis , a Common Cause of Skin and Soft Tissue Infections in the Community

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