Skin and soft tissue infections caused by Staphylococcus lugdunensis: report of 20 cases.

Staphylococcus lugdunensis is an unusually virulent coagulase-negative Staphylococcus (CoNS). The aim of the present study was to investigate the clinical and microbiological characteristics of 20 cases of skin and soft tissue infections (SSTIs) due to S. lugdunensis that occurred in our area. The frequency of SSTIs due to this organism was 0.42%. The infection was secondary to trauma, surgery or skin disease in 15 patients (75%). Abscesses (7 cases), surgical wound infections (6 cases) and cellulitis (3 cases) were the most common clinical presentations. Breast, abdomen and lower limbs were the most frequent locations. Twelve infections were community-acquired (60%) and S. lugdunensis was the only pathogen isolated from 15 of the 20 specimens (75%). All patients were cured after therapy with antibiotics, associated or not with surgical drainage. The duration of antibiotic treatment ranged from 5 to 21 days. All isolates were susceptible to most of the antibiotics tested including oxacillin. In conclusion, S. lugdunensis is a CoNS that should be considered a potential pathogen when isolated from SSTIs, especially in patients with skin diseases or after trauma or surgery. S. lugdunensis can be underrated if microbiology laboratories do not routinely identify CoNS to the species level in these infections.