Staphylococcus lugdunensis : antimicrobial susceptibility and optimal treatment options

AbstractStaphylococcus lugdunensis is a coagulase-negative staphylococcus (CoNS) with unusual pathogenicity resembling that ofS. aureus. Unlike other CoNS,S. lugdunensis remains susceptible to most antibiotics. The resistance to penicillin varies widely (range, 15 –87% worldwide), whereas methicillin resistance is still rare. We aimed to evaluate treatment options for infections caused byS. lugdunensis and more specifically to investigate whether penicillin G could be a better treatment choice than oxacillin. Susceptibility testing was performed using the disc diffusion method for penicillin G, cefoxitin, trimethoprim/sulfamethoxazole, erythromycin, clindamycin, gentamicin, norfloxacin, fusidic acid, rifampicin, and fosfomycin. Isolates susceptible to penicillin G were further tested with a gradient test for penicillin G and oxacillin. Of the 540 clinical isolates tested, 74.6% were susceptible to penicillin G. Among these penicillin-susceptible isolates, the MIC50 and MIC90 values for penicillin G were threefold lower than that for oxacillin. A majority of the isolates were susceptible to all other antibiotics tested. Breakpoints for fosfomycin have not yet been defined, and so no conclusions could be drawn. Two isolates were resistant to cefoxitin and carried themecA gene; whole-genome sequencing revealed that both harbored the SCCmec element type IVa(2B).S. lugdunensis isolated in Sweden were susceptible to most tested antibiotics. Penicillin G may be a more optimal trea...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research