Staphylococcus lugdunensis is an underestimated cause of bone and joint infections in hospital patients. According to the results of the study, presented at the 2015 Interscience Conference on Antimicrobial Agents and Chemotherapy - ICAAC), patients with this isolated pathogen should receive more aggressive treatment.

Before this study, only 47 cases of this type of infection were published in the literature, and all these publications were purely microbiological data without clinical information on the results of treatment.

If a patient receives this virulent coagulase negative staphylococcus, immediate treatment is necessary and the duration of treatment should be 2 years, since most relapses occur after 1 year.

Researchers evaluated the treatment results for 138 patients with bone and joint infections caused by S. lugdunensis, which was treated in 9 hospitals and 3 private clinics in the south of France from 1995 to 2014.

Most infections (82%) were considered to be associated with orthopedic constructions. Thus, 66 cases are infections of the prosthetic joint, 42 are infections of the joint, 3 cases are infections of the fixation structures of the spine and 2 cases of infection occurred after surgery to reconstruct the ligament. anterior crusader.

The average age of the patients was 61 years, 68% of men and 88% of cases of infection occurred more than a month after implantation of the device.

Most patients underwent surgical treatment, but results did not differ statistically significantly between patients who underwent only surgical intervention and those who underwent removal of the infected device or long-term antibiotic therapy.

After treatment, 76% of patients recovered, 19% had remission and 3% had a fatal outcome.

The strains selected S. lugdunensis a reduced sensitivity to antistaphylococcal drugs was rare, but 5 isolates were resistant to oxacillin, 4 to fosfomycin, 2 to fusidic acid, 2 to cotrimoxazole, 1 to rifampicin and 1 to clindamycin.

Coagulase-negative staphylococcus is generally considered to represent the normal microflora of the skin. However, if we are talking about implantable medical devices, catheters and other situations where a foreign device appears in the body, the colonization of these microorganisms can be pathogenic.

Although coagulase-negative staphylococci tend to cause less serious infections or the subacute course of the disease, S. lugdunensis is more virulent than other coagulase-negative staphylococci.