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Cited by 202Infective Endocarditis Diagnosis and ManagementCardiac Valve Diseases and TreatmentsOrthopedic Infections and Treatments

Staphylococcus lugdunensis infective endocarditis: description of 10 cases and analysis of native valve, prosthetic valve, and pacemaker lead endocarditis clinical profiles

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Anguera, I, Del Río, A, Miró, J M, Matínez-Lacasa, X, Marco, F, Gumá, J R, Quaglio, G, Claramonte, X +11 more·2005·Heart
DOI 10.1136/hrt.2004.040659PMC PMC1768720
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Abstract

Objective: To evaluate the incidence and the clinical and echocardiographic features of infective endocarditis (IE) caused by Staphylococcus lugdunensis and to identify the prognostic factors of surgery and mortality in this disease. Design: Prospective cohort study. Setting: Study at two centres (a tertiary care centre and a community hospital). Patients: 10 patients with IE caused by S lugdunensis in 912 consecutive patients with IE between 1990 and 2003. Methods: Prospective study of consecutive patients carried out by the multidisciplinary team for diagnosis and treatment of IE from the study institutions. English, French, and Spanish literature was searched by computer under the terms “endocarditis” and “Staphylococcus lugdunensis” published between 1989 and December 2003. Main outcome measures: Patient characteristics, echocardiographic findings, required surgery, and prognostic factors of mortality in left sided cases of IE. Results: 10 cases of IE caused by S lugdunensis were identified at our institutions, representing 0.8% (four of 467), 1.5% (two of 135), and 7.8% (four of 51) of cases of native valve, prosthetic valve, and pacemaker lead endocarditis in the non-drug misusers. Native valve IE was present in four patients (two aortic, one mitral, and one pulmonary), prosthetic valve aortic IE in two patients, and pacemaker lead IE in the other four patients. All patients with left sided IE had serious complications (heart failure, periannular abscess formation, or shock) requiring surgery in 60% (three of five patients) of cases with an overall mortality rate of 80% (four of five patients). All patients with pacemaker IE underwent combined medical treatment and surgery, and mortality was 25% (one patient). In total 59 cases of IE caused by S lugdunensis were identified in a review of the literature. The combined analysis of these 69 cases showed that native valve IE (53 patients, 77%) is characterised by mitral valve involvement and frequent complications such as heart failure, abscess formation, and embolism. Surgery was needed in 51% of cases and mortality was 42%. Prosthetic valve endocarditis (nine of 60, 13%) predominated in the aortic position and was associated with abscess formation, required surgery, and high mortality (78%). Pacemaker lead IE (seven of 69, 10%) is associated with a better prognosis when antibiotic treatment is combined with surgery. Conclusions: S lugdunensis IE is an uncommon cause of IE, involving mainly native left sided valves, and it is characterised by an aggressive clinical course. Mortality in left sided native valve IE is high but the prognosis has improved in recent years. Surgery has improved survival in left sided IE and, therefore, early surgery should always be considered. Prosthetic valve S lugdunensis IE carries an ominous prognosis.

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  1. [7]7. Walsh B, Mounsey JP. Staphylococcus lugdunensis and endocarditis [letter]. J Clin Pathol 1990;43:171.
  2. [41]41. Garcia Fernandez FJ, Berjon Reyero J, Ruiz Quevedo V, et al. [Staphylococcus lugdunensis endocarditis. Case report and review of the literature]. Rev Clin Esp 2003;2:98-9.
  3. [43]43. Rodriguez-Gascon M, Roig P, Montagud JB, et al. [Acute Staphylococcus lugdunensis endocarditis with septic cerebral and pulmonary emboli, showing favorable evolution]. Enferm Infecc Microbiol Clin 2003;8:465-7.

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Authors
Anguera, I., Del Río, A., Miró, J. M., Matínez-Lacasa, X., Marco, F., Gumá, J. R., Quaglio, G., Claramonte, X., Moreno, A., Mestres, C. A., Mauri, E., Azqueta, M., Benito, N., García-de la María, C., Almela, M., Jiménez-Expósito, M.-J., Sued, O., De Lazzari, E., & Gatell, J. M.
Affiliations
  • Corporació Sanitària Parc Taulí (ES)
  • University Hospital Mútua de Terrassa (ES)
  • Universitat de Barcelona (ES)
ORCID
Venue
Heart
Publisher
BMJ
Published
2005-01-18
Volume
91
Issue
2
Pages
e10-e10
ISSN
  • 1355-6037 (ISSN-L)
  • 1468-201X
DOI
10.1136/hrt.2004.040659
PMC
PMC1768720
OpenAlex
W2098666854
Semantic Scholar
14e79e7a9fe42526979a2cdfdd3469fc6e6b70b6
Cited by
202
References
56
Citations by year
2026: 4 · 2025: 3 · 2024: 4 · 2023: 11 · 2022: 10 · 2021: 11 · 2020: 13 · 2019: 10 · 2018: 9 · 2017: 6 · 2016: 10 · 2015: 11 · 2014: 13 · 2013: 6 · 2012: 8
FWCI
7.82
Type
journal article
Language
en
Open access
Locations
  • Heart (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion)
  • RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, public-domain)
Topics
  • Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Surgery › Orthopedic Infections and Treatments
Keywords
Staphylococcus lugdunensis, infective endocarditis, native valve endocarditis, prosthetic valve endocarditis, mitral valve involvement, surgical treatment, mortality, prognostic factors, heart failure, abscess formation, embolism, left-sided endocarditis, echocardiographic features
MeSH terms
Adult, Aged, Anti-Bacterial Agents, Cardiac Pacing, Artificial, Endocarditis, Bacterial, Female, Heart Valve Prosthesis, Humans, Male, Middle Aged, Pacemaker, Artificial, Prospective Studies, Staphylococcal Infections, Ultrasonography, Cohort Studies, Survival Analysis, Prosthesis-Related Infections, Treatment Outcome

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