Staphylococcus lugdunensis bacteremia: clinical implications of single set positive blood cultures

Elsevier

Available online 17 October 2022, 115835

Diagnostic Microbiology and Infectious DiseaseAbstract

Staphylococcus lugdunensis is exceptionally virulent among the coagulase-negative Staphylococcus species, but the clinical significance of single-positive bacteremia of S. lugdunensis remains uncertain. We investigated S. lugdunensis bacteremia cases over ten years. Of the 49 cases included, 12 had multiple-positive blood cultures and 37 had single-positive blood culture. Antimicrobial therapy was given to over 80% of both groups, whereas the duration of therapy was significantly longer in the multiple-positive group. The overall 30-day and 90-day mortality rates were 13.3% and 18.2%, and 36.7% and 18.2% for single and multiple-positive patients, respectively. Five single-positive patients without therapy did not have severe infection, presumed source of infection or culture positivity within 20 hours, but all defervesced within two days and were alive at 30 days. While the clinical spectrum of single-positive S. lugdunensis bacteremia is broad, antimicrobial therapy may be withheld without adverse clinical consequences in a subset of low-risk patients.

Keywords

staphylococci

blood culture

antimicrobial therapy

antimicrobial stewardship

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