Introduction

S. lugdunensis is increasingly recognized as a significant pathogen in skin infections, not just an opportunistic organism. It is more virulent than other coagulase-negative staphylococci (CoNS) and associated with aggressive infections, including infective endocarditis, osteomyelitis, and skin and soft tissue infections (SSTIs), particularly in areas below the waist.

Aim

To characterize the clinical and microbiological profile of patients with S. lugdunensis skin infections

Patient Profile

• Patients who were diagnosed with SSTIs caused by lugdunensis at a single center
• N=123 skin specimens positive for lugdunensis

Methods

• Retrospective analysis of patient records over ten-year period

Study endpoints

Patient demographics, clinical presentations, comorbidities, and treatment responses

Results

Clinical Characteristics

• Gender:4% males and 49.6% females
• Mean age:24 years
• Specimen source: Pus (84%), primarily from below the waist (66.7%)
• Conditions associated with S. lugdunensis: Hidradenitis suppurativa (26%) was most common, followed by folliculitis, abscesses, ulcers, cellulitis, and acne.
• Bacterial co-infections:6% of cases
• Source of infection:2% of infections were nosocomially acquired

Treatment and Outcomes

• 65% patients received systemic antibiotics with 100% cure rate
• Commonly used antibiotics: Predominantly amoxicillin/clavulanic acid (22.8%), cefuroxime axetil (15.4%), and doxycycline (14.6%)

Antibiotic Susceptibility

• All isolates were susceptible to linezolid, moxifloxacin, rifampicin, teicoplanin, tigecycline, trimethoprim/sulfamethoxazole, and vancomycin
• Resistance rates were highest for clindamycin (36%), penicillin (28.5%), and erythromycin (26%)
• Methicillin resistance was low at 4.9%, indicating that most strains remain susceptible to beta-lactams

Conclusion

• lugdunensis was found to be significant pathogen in skin infections, capable of causing severe disease
• High cure rate indicative of the effectiveness of appropriate antibiotic therapy

Reference

J Clin Med. 2024 Jul 24;13(15):4327