Background

Staphylococcus lugdunensis is a coagulase negative Staphylococcus species and frequent human skin commensal with the potential for aggressive infection. Guidance surrounding S. lugdunensis bacteremia (SLB) from a single set of blood cultures is lacking.

Methods

A multicenter, retrospective cohort of patients with SLB from at least one blood culture set within the University of Maryland Medical System from 2015 to 2019 is presented. Objectives are to describe baseline characteristics, compare the clinical status and treatment course, and to evaluate the clinical outcomes among patients with SLB in single versus multiple sets.

Results

Thirty-six patients were included, 24 with one set of blood cultures positive for S lugdunensis and 12 with multiple sets. Baseline characteristics were similar between the groups, though patients with SLB in multiple sets were more commonly on hemodialysis (P = 0.029). Central lines were the most common source (17%). Most (97%) fulfilled systemic inflammatory response syndrome or Souvenir criteria, had an infectious focus on imaging, or had a second positive culture site. Most (78%) were treated as clinically significant. Patients with multiple positive sets were more commonly treated with antibiotics for >2 weeks (P = 0.02).

Conclusions

SLB was rare and occurred more frequently as a single set of positive cultures. Patient characteristics and clinical courses were similar between single and multiple set groups. Given the potential severity of S. lugdunensis bacteremia it seems prudent to treat S. lugdunensis in a single blood culture as true bacteremia, pending larger studies and guidelines.

中文翻译：

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从单一血培养组中分离出路敦葡萄球菌临床意义的多中心回顾性队列研究

背景

路敦葡萄球菌是一种凝固酶阴性葡萄球菌，常与人类皮肤共生，具有侵袭性感染的潜力。缺乏从单组血培养中围绕S. lugdunensis菌血症 (SLB) 的指导。

方法

介绍了 2015 年至 2019 年马里兰大学医学系统内至少一个血培养组的多中心、回顾性 SLB 患者队列。目的是描述基线特征，比较临床状态和治疗过程，并评估单组和多组 SLB 患者的临床结果。

结果

包括 36 名患者，其中 24 名具有一组血培养对S lugdunensis呈阳性反应，12 名具有多组血培养。两组间的基线特征相似，但多组 SLB 患者更常接受血液透析（P  = 0.029）。中心线是最常见的来源 (17%)。大多数 (97%) 符合全身炎症反应综合征或纪念品标准，在影像学上有感染焦点，或有第二个阳性培养部位。大多数 (78%) 被视为具有临床意义。多组阳性患者更常使用抗生素治疗 >2 周（P  = 0.02）。

结论

SLB 是罕见的，并且更频繁地作为一组阳性培养物发生。单组和多组之间的患者特征和临床过程相似。鉴于S. lugdunensis菌血症的潜在严重性，将单一血培养中的S. lugdunensis视为真正的菌血症似乎是谨慎的，有待更大规模的研究和指南。