1553. Staphylococcus lugdunensis infection in Cancer Patients
Session: Poster Abstract Session: Infections in the Immunocompromised Hosts
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • poster staph lug for idweek.pdf (769.3 kB)
  • Background:

    Coagulase negative staphylococci (CNS) are common skin colonizers and often cause catheter-related bloodstream infection (CRBSI), but cause other serious infections infrequently. Staphylococcus lugdunensis (S. lug) is a CNS species that is considered more virulent. Most reports are individual cases or small series, and none describe the spectrum of infection or outcomes in cancer patients.

    Methods:

    We conducted a retrospective chart review of cancer patients between 1/1/2011 – 3/30/2013 from whom S. lug was isolated from the blood stream or other sterile body sites .Only monomicrobial infections were studied, although 25 polymicrobial infections were also identified.   

    Results:

    45 patients had a clinically significant monomicrobial S. lug infection with 26 (58%) being female, 37 (82%) with an underlying solid tumor and 7 (15%), a hematologic malignancy (HM). Only 2(4.4%)were neutropenic. Five (11%) had a blood stream infection (BSI), four of which had HM. Of these 1 had endocarditis / perivalvular abscess and required valve replacement. 36 (80%) had abscesses. All underwent drainage initially 16 (45%) or following inadequate response 20 (55%) to medical therapy. Post-surgical infections occurred in 23 (51%), and implanted devices (expanders, artificial knee, omaya reservoir) were involved in 7 (30%) . Other sites included the urinary tract (2), meningitis and empyema (one each). Echocardiography was done in the 5 patients with BSI with significant findings in only one patient. Oxacillin susceptibility was 89%. All isolates were vancomycin susceptible. Numerous agents were used for therapy.  No deaths occurred within 30 days, and 4 (9%) died during follow up (average of 298 days). None died from infection related causes.

    Conclusion:

    Unlike other CNS species S. lug cause CRBSI infrequently. Deep-seated abscesses and post-surgical infections involving foreign medical devices are more common. Uniform vancomycin susceptibility was noted. Drainage of abscess in addition to antimicrobial therapy seems to be essential for infection resolution. In cancer patients S. lug should be treated as a potentially serious pathogen and should not be dismissed as a contaminant.

    Lior Nesher, M.D.1, Jeffrey J. Tarrand, MD2 and Kenneth V. I. Rolston, M.D.1, (1)Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, (2)Department of Laboratory Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX

    Disclosures:

    L. Nesher, None

    J. J. Tarrand, None

    K. V. I. Rolston, None

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