Journal
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
Volume 105, Issue 1, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2022.115835
Keywords
Staphylococci; Blood culture; Antimicrobial therapy; Antimicrobial stewardship
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This study investigated cases of S. lugdunensis bacteremia and found that the clinical significance of single-positive cases is uncertain. Among all cases, only a small subset of low-risk patients did not require antimicrobial therapy, and they had no adverse clinical consequences.
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 10 years. Of the 49 cases included, 12 had multiple-positive blood cultures and 37 had single-positive blood cultures. 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 2 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. (c) 2022 Elsevier Inc. All rights reserved.
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