title: Clinical experience and microbiologic characteristics of invasive Staphylococcus lugdunensis infection in a tertiary center in northern Taiwan.
abstract: OBJECTIVE
  Staphylococcus lugdunensis is a coagulase-negative staphylococcus that cannot be ignored. This study is a comprehensive analysis of the clinical and microbiological characteristics of S. lugdunensis bacteremia and sterile site infection during hospitalization.
  
  
  METHODS
  This retrospective study included 48 patients with invasive S. lugdunensis infection. During the period of March 2002 to July 2012, they had been hospitalized in a tertiary center of northern Taiwan. Demographics, clinical characteristics, and risk factors of mortality were analyzed. All isolates were tested for antimicrobial susceptibility. We identified the staphylococcal cassette chromosome mec (SCCmec) gene for oxacillin nonsusceptible isolates.
  
  
  RESULTS
  The incidence of S. lugdunensis in coagulase-negative staphylococci bacteremia was 0.87%. Forty-eight patients were enrolled: S. lugdunensis was present in 41 patients with bacteremia, in the ascites of three patients, in the synovial fluid of two patients, in the pleural effusion of one patient, and in the amniotic fluid of one patient. The three most common sources of infection were primary bacteremia (43.8%), catheter-related infection (18.8%), and vascular graft infection (12.5%). All-cause mortality during hospitalization was 20.8% (10/48). All deceased patients were bacteremic. Risk factors associated with in-hospital mortality included a Pittsburgh bacteremia score of 2 or greater, infective endocarditis, and end-stage renal disease. Ten (20.8%) isolates were resistant to oxacillin, and 8 isolates were classified as SCCmec type V.
  
  
  CONCLUSIONS
  The clinical significance of S. lugdunensis should not be ignored, especially in patients with severe comorbidities. An aggressive search for endocarditis is strongly suggested in S. lugdunensis bacteremic cases.
authors: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Jung-Fu
authors: JF
authors: Lin
authors: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Chun-Wen
authors: CW
authors: Cheng
authors: Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan.
authors: An-Jing
authors: AJ
authors: Kuo
authors: Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan.
authors: Tsui-Ping
authors: TP
authors: Liu
authors: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Chien-Chang
authors: CC
authors: Yang
authors: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Ching-Tai
authors: CT
authors: Huang
authors: Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Ming-Hsun
authors: MH
authors: Lee
authors: Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taoyuan, Taiwan; Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: janglu45@gmail.com.
authors: Jang-Jih
authors: JJ
authors: Lu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000382:microbiology; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality / Q000473:pathology*; D005260:Female; D005798:Genes, Bacterial; D056426:Genetic Loci; D006801:Humans; D015994:Incidence; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010996:Pleural Effusion / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality / Q000473:pathology*; D057787:Staphylococcus lugdunensis / Q000302:isolation & purification*; D016019:Survival Analysis; D013582:Synovial Fluid / Q000382:microbiology; D013624:Taiwan / Q000453:epidemiology; D062606:Tertiary Care Centers
keywords: Bacteremia; Endocarditis; SCCmec type; Staphylococcus lugdunensis