Staphylococcus lugdunensis

Staphylococcus lugdunensis is a spherical, Gram-positive, facultative anaerobic bacterium that belongs to the Staphylococcus genus and Staphylococcaceae family. The bacterium occurs in isolation, in short chains, or in small clusters. Staphylococcus lugdunensis belongs to the coagulase-negative Staphylococci (CNS) [1], while S. epidermidis is also a member of the CNS group. A special characteristic of Staphylococcus lugdunensis is its ability to produce the antibiotic lugdunin, which can kill S. aureus in vitro.

Unlike the coagulase-producing S. aureus, CNS species are considered less pathogenic to humans. S. lugdunensis is an exception and it is characterized as the most virulent species of the CNS [1]. While the bacteria occur less commonly, they can trigger life-threatening infections that, in terms of their severity, are comparable to the infections caused by S. aureus [1][2][3][4].

Possible clinical pictures include:

  • Infections of the skin and soft tissues

  • Bone and joint infections

  • Infections in prosthetic joints

  • Infections associated with vascular catheters and abscesses

  • Infectious endocarditis

S. lugdunensis is part of the human skin flora and predominantly colonizes the lower half of the body, especially the groin and perineal region and the nail beds of the feet. The colonization rate within the population is around 67% [1][2][4].

Relevance of pathogen in transmission in endoscopy

  • Gastroenterology: Low

  • Pulmonology: Low

  • Ear, nose, and throat: Low

  • Urology: Low

Relevance for endoscope surveillance

  • High concern organism

Transmission route

Transmission is predominantly by direct or indirect contact, primarily with colonized skin. The pathogen can also be transmitted via contaminated objects such as catheters, implants, and cannulas [1][5].

Resistance to antibiotics

Unlike other CNS representatives, S. lugdunensis is considered to be highly susceptible to a broad spectrum of antibiotics. Some studies report cases of resistance to betalactam antibiotics [5]. In the USA, a resistance rate to penicillin of 45% has been observed [1]. There have also been isolated reports of resistance to erythromycin, streptomycin, tetracycline, penicillin, gentamicin, and ceftazidime, as well as aminoglycosides and macrolides. Thus far, multidrug resistance has only been demonstrated in one S. lugdunensis isolate [1].

Sources and further readings

  1. Heilbronner S, Foster TJ. Staphylococcus lugdunensis a Skin Commensal with Invasive Pathogenic Potential. Clin Microbiol Rev. 2021, 34 (2): e00205-20.

  2. Bieber L, Kahlmeter G. et al. Staphylococcus lugdunensis in several niches of the normal skin flora. Clin Microbiol Infect. 2010, 16: 385–388.

  3. Parthasarathy S, Shah S, Raja Sager A, Rangan A, Durugu S. Staphylococcus lugdunensis: Review of Epidemiology, Complications, and Treatment. Cureus. 2020, 12:6-13.

  4. Böcher S, Tønning B, Skov RL, Prag J. Staphylococcus lugdunensis, a common cause of skin and soft tissue infections in the community. J Clin Microbiol. 2009, 47 (4):946-50.

  5. Frank KL, Del Pozo JL, Patel R. From clinical microbiology to infection pathogenesis: how daring to be different works for Staphylococcus lugdunensis. Clin Microbiol Rev. 2008,21 (1):111-33.