title: Staphylococcus lugdunensis infections, filling in the gaps: a 3-year retrospective review from a comprehensive cancer center.
abstract: Staphylococcus lugdunensis is considered to be more aggressive than other coagulase-negative staphylococci (CoNS). There are gaps in knowledge regarding the importance of isolating S. lugdunensis from different sources and in different patient subsets. Our objective was to describe the spectrum, clinical manifestations, and outcomes of infections caused by S. lugdunensis in patients with cancer.
  
  
  
  A retrospective review of all cancer patients from whom S. lugdunensis was isolated in a pure culture from clinically significant sites.
  
  
  
  Between 2011 and 2014, 2263 CoNS were isolated, of them 45 S. lugdunensis were isolated in a pure culture and were included in this analysis. Only three patients were neutropenic. Skin and skin structure infections (SSSIs) occurred most often (36 cases) followed by five blood stream infections, one of which had destructive endocarditis and four infections at other sites. Of the 36 SSSIs, 29 were related to surgical or invasive procedures, and six of these involved an implanted medical device. All isolates were susceptible to vancomycin, 98% to levofloxacin and 89% to oxacillin. All patients responded to the therapy.
  
  
  
  Cancer patients including those with neutropenia do not appear to have an increased frequency of infections caused by S. lugdunensis. SSSIs are predominant and are often associated with surgical procedures and/or implanted medical devices. Blood stream infections caused by S. lugdunensis are uncommon but may have an increased rate of serious complications such as endocarditis. Nevertheless, these organisms are generally susceptible to multiple classes of antimicrobial agents, and the overall response to therapy is high.
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. nesherke@bgu.ac.il.|Infectious Disease Institute, Faculty of health sciences, Ben-Gurion University, Soroka Medical Center, 84101, Beer-Sheba, Israel. nesherke@bgu.ac.il.
authors.forename: Lior
authors.identifier: http://orcid.org/0000-0002-1230-0428
authors.initials: L
authors.lastname: Nesher
authors.affiliation: Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Jeffery
authors.initials: J
authors.lastname: Tarrand
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Kenneth Vi
authors.initials: KV
authors.lastname: Rolston
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000382:microbiology*; D012189:Retrospective Studies; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D057787:Staphylococcus lugdunensis / Q000187:drug effects / Q000302:isolation & purification*; D014640:Vancomycin / Q000494:pharmacology; D055815:Young Adult
chemical_list: D014640:Vancomycin
keywords: Cancer patients; Skin/skin structure infection; Staphylococcus lugdunensis