title: Frequency, clinical manifestations, and outcomes of Staphylococcus lugdunensis Bacteremia in children.
abstract: BACKGROUND
  Staphylococcus lugdunensis (S. lugdunensis) is known as a common cause of clinically significant infections in adults although the clinical importance of S. lugdunensis isolates from pediatric samples is less known. The aim of this study is to assess the incidence, characteristics, and outcomes of S. lugdunensis bacteremia (SLB) in children.
  
  
  METHODS
  From January 2009 to March 2014, all blood culture isolates were retrospectively screened for S. lugdunensis. We analyzed the isolates for antimicrobial susceptibility and patients who had developed SLB by reviewing the electronic medical records. Additionally, we identified mecA and blaZ for available isolates by polymerase chain reaction (PCR).
  
  
  RESULTS
  Of the 647 positive blood cultures during the period, 277 (42.8%) yielded coagulase negative Staphylococcus (CoNS), and 10 of 277 CoNS were S. lugdunensis (3.6% of all CoNS isolates). Of eight SLB episodes identified, seven (87.5%) were considered to have clinically significant bacteremia. All patients had underlying diseases, and all SLB were either healthcare-associated or hospital acquired. There was no infectious endocarditis (IE) development. All patients were treated with antibiotics and recovered without sequelae. We found that the isolates in our study showed higher antibiotic resistance to penicillin (8/8: 100%) and oxacillin (6/8: 75.0%) than previously reported. Among isolates available, we detected mecA in all four isolates resistant to oxacillin and blaZ in 5 of 6 isolates resistant to penicillin.
  
  
  CONCLUSIONS
  S. lugdunensis is a rare but an important cause of bacteremia in children.
authors.affiliation: Department of Pediatric Intensive Care, Nagano Children's Hospital, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Laboratory Medicine, Nagano Children's Hospital, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kubota
authors.affiliation: Department of Laboratory Medicine, Nagano Children's Hospital, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Horiuchi
authors.affiliation: Department of Pediatric Intensive Care, Nagano Children's Hospital, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kasai
authors.affiliation: Department of General Pediatrics, Nagano Children's Hospital, Japan.
authors.forename: Kisei
authors.initials: K
authors.lastname: Minami
authors.affiliation: Department of Pediatric Intensive Care, Nagano Children's Hospital, Japan. Electronic address: hikoromatsui@googlemail.com.
authors.forename: Hikoro
authors.initials: H
authors.lastname: Matsui
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D001426:Bacterial Proteins; D002648:Child; D002675:Child, Preschool; D003030:Coagulase; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D057787:Staphylococcus lugdunensis / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D003030:Coagulase
keywords: Bacteremia; Children; Coagulase negative Staphylococcus; Staphylococcus lugdunensis