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Cureus Jun 2020is a species of coagulase-negative staphylococci (CNS) that induces a variety of infectious diseases, including skin and soft tissue infection (SSTI), infective... (Review)
Review
is a species of coagulase-negative staphylococci (CNS) that induces a variety of infectious diseases, including skin and soft tissue infection (SSTI), infective endocarditis (IE), and bone and PJI. This review article underscores the important points in the literature about infections, including its epidemiology, diagnosis, and treatment, as well as specific types of infections it can cause. Anatomical and age-related distributions of SSTIs have been noted, though they most commonly occur as abscesses. can also manifest as an aggressive form of IE presenting with valve destruction and abscess formation, frequently requiring surgery and with a high mortality rate. Bone and joint infections caused by are also more invasive than infections by other species of CNS. The clinical presentation of infection in SSTI, IE, and bone/joint infection is frequently more similar to that of infection than that of other CNS infections, necessitating species-level differentiation of CNS for proper diagnosis. Though historically, this depended upon biochemical tests that were neither routine nor reliable, the implementation of matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) in clinical laboratories has made identification of CNS species such as more practical. Imaging modalities, especially the fluorodeoxyglucose (FDG) with positron emission tomography (PET), are another important emerging trend in the diagnosis of infectious diseases such as infection. remains highly susceptible to a wide gamut of antibacterial therapies, which is uncharacteristic of other CNS. Infections can usually be treated by antibiotics traditionally used for CNS such as oxacillin. The breakpoints for are higher than those of other CNS and similar to breakpoints. In the case of aggressive IE or bone/joint infection by , it is recommended to treat with a β-lactam agent. Further study is needed to understand the diversity, virulence, and population structure of this species, as well as its role in other infections, such as urinary tract infections (UTIs), respiratory infections, peritonitis, and bacteremia.
PubMed: 32617242
DOI: 10.7759/cureus.8801 -
Clinical Microbiology Reviews Oct 2014The definition of the heterogeneous group of coagulase-negative staphylococci (CoNS) is still based on diagnostic procedures that fulfill the clinical need to... (Review)
Review
The definition of the heterogeneous group of coagulase-negative staphylococci (CoNS) is still based on diagnostic procedures that fulfill the clinical need to differentiate between Staphylococcus aureus and those staphylococci classified historically as being less or nonpathogenic. Due to patient- and procedure-related changes, CoNS now represent one of the major nosocomial pathogens, with S. epidermidis and S. haemolyticus being the most significant species. They account substantially for foreign body-related infections and infections in preterm newborns. While S. saprophyticus has been associated with acute urethritis, S. lugdunensis has a unique status, in some aspects resembling S. aureus in causing infectious endocarditis. In addition to CoNS found as food-associated saprophytes, many other CoNS species colonize the skin and mucous membranes of humans and animals and are less frequently involved in clinically manifested infections. This blurred gradation in terms of pathogenicity is reflected by species- and strain-specific virulence factors and the development of different host-defending strategies. Clearly, CoNS possess fewer virulence properties than S. aureus, with a respectively different disease spectrum. In this regard, host susceptibility is much more important. Therapeutically, CoNS are challenging due to the large proportion of methicillin-resistant strains and increasing numbers of isolates with less susceptibility to glycopeptides.
Topics: Coagulase; Disease Management; Drug Resistance, Bacterial; Humans; Microbial Sensitivity Tests; Staphylococcal Infections; Staphylococcus
PubMed: 25278577
DOI: 10.1128/CMR.00109-13 -
International Journal of Molecular... Mar 2019Coagulase-negative Staphylococci (CoNS) are skin commensal bacteria. Besides their role in maintaining homeostasis, CoNS have emerged as major pathogens in nosocomial... (Review)
Review
Coagulase-negative Staphylococci (CoNS) are skin commensal bacteria. Besides their role in maintaining homeostasis, CoNS have emerged as major pathogens in nosocomial settings. Several studies have investigated the molecular basis for this emergence and identified multiple putative virulence factors with regards to pathogenicity. In the last decade, numerous CoNS whole-genome sequences have been released, leading to the identification of numerous putative virulence factors. Koch's postulates and the molecular rendition of these postulates, established by Stanley Falkow in 1988, do not explain the microbial pathogenicity of CoNS. However, whole-genome sequence data has shed new light on CoNS pathogenicity. In this review, we analyzed the contribution of genomics in defining CoNS virulence, focusing on the most frequent and pathogenic CoNS species: , , , and .
Topics: Coagulase; Genome, Bacterial; Genomics; Humans; Phylogeny; Staphylococcal Infections; Staphylococcus; Virulence; Virulence Factors
PubMed: 30862021
DOI: 10.3390/ijms20051215 -
Current Rheumatology Reports Jul 2021This article presents a comprehensive narrative review of reactive arthritis (ReA) with focus on articles published between 2018 and 2020. We discuss the entire spectrum... (Review)
Review
PURPOSE OF REVIEW
This article presents a comprehensive narrative review of reactive arthritis (ReA) with focus on articles published between 2018 and 2020. We discuss the entire spectrum of microbial agents known to be the main causative agents of ReA, those reported to be rare infective agents, and those reported to be new candidates causing the disease. The discussion is set within the context of changing disease terminology, definition, and classification over time. Further, we include reports that present at least a hint of effective antimicrobial therapy for ReA as documented in case reports or in double-blind controlled studies. Additional information is included on microbial products detected in the joint, as well as on the positivity of HLA-B27.
RECENT FINDINGS
Recent reports of ReA cover several rare causative microorganism such as Neisseria meningitides, Clostridium difficile, Escherichia coli, Hafnia alvei, Blastocytosis, Giardia lamblia, Cryptosporidium, Cyclospora cayetanensis, Entamoeba histolytica/dispar, Strongyloides stercoralis, β-haemolytic Streptococci, Mycobacterium tuberculosis, Mycoplasma pneumoniae, Mycobacterium bovis bacillus Calmette-Guerin, and Rickettsia rickettsii. The most prominent new infectious agents implicated as causative in ReA are Staphylococcus lugdunensis, placenta- and umbilical cord-derived Wharton's jelly, Rothia mucilaginosa, and most importantly the SARS-CoV-2 virus. In view of the increasingly large spectrum of causative agents, diagnostic consideration for the disease must include the entire panel of post-infectious arthritides termed ReA. Diagnostic procedures cannot be restricted to the well-known HLA-B27-associated group of ReA, but must also cover the large number of rare forms of arthritis following infections and vaccinations, as well as those elicited by the newly identified members of the ReA group summarized herein. Inclusion of these newly identified etiologic agents must necessitate increased research into the pathogenic mechanisms variously involved, which will engender important insights for treatment and management of ReA.
Topics: Arthritis, Reactive; Blastocystis Infections; COVID-19; Clostridium Infections; Cryptosporidiosis; Cyclosporiasis; Entamoebiasis; Enterobacteriaceae Infections; Escherichia coli Infections; Giardiasis; HLA-B27 Antigen; Humans; Meningococcal Infections; Pneumonia, Mycoplasma; Prohibitins; Rocky Mountain Spotted Fever; SARS-CoV-2; Staphylococcal Infections; Streptococcal Infections; Strongyloidiasis; Tuberculosis
PubMed: 34196842
DOI: 10.1007/s11926-021-01018-6 -
Clinical Microbiology and Infection :... Sep 2019Progress in contemporary medicine is associated with an increasing number of immunocompromised individuals. In this vulnerable group, the underlying disease together... (Review)
Review
BACKGROUND
Progress in contemporary medicine is associated with an increasing number of immunocompromised individuals. In this vulnerable group, the underlying disease together with long-term hospitalization and the use of medical devices facilitate infections by opportunistic pathogens, of which coagulase-negative staphylococci (CoNS) represent a prime example.
OBJECTIVES
The diversity of CoNS with species- and strain-specific differences concerning virulence and clinical impact is highlighted. A focus is on the ability of CoNS to generate biofilms on biotic and abiotic surfaces, which enables skin and mucosa colonization as well as establishment of CoNS on indwelling foreign bodies.
SOURCES
Literature about the virulence of CoNS listed in PubMed was reviewed.
CONTENT
Most catheter-related and prosthetic joint infections as well as most other device-related infections are caused by CoNS, specifically by Staphylococcus epidermidis and Staphylococcus haemolyticus. A common theme of CoNS infections is a high antibiotic resistance rate, which often limits treatment options and contributes to the significant health and economic burden imposed by CoNS.
IMPLICATIONS
Breaching the skin barrier along with the insertion of medical devices offers CoNS opportunities to gain access to host tissues and to sustain there by forming biofilms on foreign body surfaces. Biofilms represent the perfect niche to protect CoNS from both the host immune response and the action of antibiotics. Their particular lifestyle, combined with conditions that facilitate host colonization and infection, has led to the growing impact of CoNS as pathogens. Moreover, CoNS may serve as hidden reservoirs for antibiotic resistance and virulence traits.
Topics: Animals; Anti-Bacterial Agents; Biofilms; Catheter-Related Infections; Coagulase; Drug Resistance, Multiple, Bacterial; Humans; Staphylococcal Infections; Staphylococcus; Virulence
PubMed: 30502487
DOI: 10.1016/j.cmi.2018.11.012 -
Antibiotics (Basel, Switzerland) Oct 2022endophthalmitis is an uncommon intraocular infection with potentially visually devastating consequences. endophthalmitis have been reported following cataract surgery,...
endophthalmitis is an uncommon intraocular infection with potentially visually devastating consequences. endophthalmitis have been reported following cataract surgery, trauma, intravitreal injections of anti-vascular endothelial growth factor agents and dexamethasone implant. We report four cases of postoperative endophthalmitis after cataract extraction (three patients) and combined pars plana vitrectomy and cataract extraction (one patient). The onset of presentation of endophthalmitis was acute (within 2 weeks) in two patients, subacute (2 to 6 weeks) in one patient, and chronic (more than 6 weeks) in one patient. All patients had presenting visual acuity (VA) of hand motions or worse and were treated with pars plana vitrectomy with intravitreal antibiotics. The final VA was 20/50 in two patients, 4/200 in one patient with pre-existing myopic maculopathy, and no light perception in one patient with retinal detachment. In antibiotic susceptibility testing, isolates were resistant to penicillin (3/4, 75%), but all were susceptible to vancomycin, oxacillin, teicoplanin, tigecycline, and sulfamethoxazole-trimethoprim. may be associated with acute or chronic endophthalmitis. Favorable visual outcomes can be achieved with prompt diagnosis and management.
PubMed: 36358140
DOI: 10.3390/antibiotics11111485 -
Cureus Nov 2020Staphylococcus species are a leading cause of community-acquired bacteremia. Of them, the most serious cause of mortality is from methicillin-resistant Staphylococcus...
Staphylococcus species are a leading cause of community-acquired bacteremia. Of them, the most serious cause of mortality is from methicillin-resistant Staphylococcus aureus, with mortality rates as high as 40%. Another Staphylococcus species that has been noted to cause equal levels of infection and mortality is Staphylococcus lugdunensis (S. lugdunensis). It can cause harmless skin infections to life-threatening endocardial complications. We would like to report a rare presentation of S. lugdunensis bacteremia from a lymphocele that developed post surgery. An 80-year-old male presented to the emergency department with complaints of abdominal pain and fevers. Cultures of lymphocele fluid grew S. lugdunensis. A computed tomography of the abdomen and pelvis with contrast showed the presence of a large lymphocele. S. lugdunensis is a coagulase-negative staphylococci normally known to be a skin colonizer. Over the years, it has shown to cause a wide variety of infections especially involving prosthetic joints and heart valves. S. lugdunensis has been noted to be highly susceptible to penicillins, such as oxacillin, erythromycin, linezolid and a wide a variety of other antibiotics. S. lugdunensis produces a biofilm that makes treatment challenging even with susceptible antibiotics. However, the data on S. lugdunensis is growing as more case reports are being published in regards to source and susceptibilities.
PubMed: 33391904
DOI: 10.7759/cureus.11666 -
Journal of Clinical Microbiology Jan 2022Evaluation of penicillin and oxacillin susceptibility testing was conducted on 200 Staphylococcus lugdunensis isolates. Disc diffusion with penicillin 1 IU (P1, EUCAST)...
Evaluation of penicillin and oxacillin susceptibility testing was conducted on 200 Staphylococcus lugdunensis isolates. Disc diffusion with penicillin 1 IU (P1, EUCAST) and penicillin 10 IU (P10, CLSI) was compared with nitrocefin discs (Cefinase) and automated broth microdilution (Vitek 2). Oxacillin susceptibility was extrapolated from cefoxitin (FOX; 30 μg) disc diffusion and compared with Vitek 2 results. The reference methods were and PCR. Penicillin zone diameter and zone edge correlated with PCR results in all except two P10-susceptible isolates (very major error [VME]) and one P1-resistant isolate (major error [ME]). A total of 148 isolates were negative, of which 146 and 149 isolates were susceptible by P1 and P10, respectively. A total of 127 were penicillin susceptible by Vitek 2. Vitek 2 overcalled resistance in 21 -negative, 20 P1-susceptible, and 22 P10-susceptible isolates (Vitek 2 ME rate, 14.2%). Two -positive isolates were oxacillin resistant by FOX disc and Vitek 2 methods (categorical agreement). However, 18 FOX-susceptible -negative isolates tested resistant by Vitek 2. In conclusion, Vitek 2 overestimated penicillin and oxacillin resistance compared with disc diffusion and PCR results. In our study, disc diffusion with zone edge interpretation was more accurate and specific than automated broth microdilution for S. lugdunensis.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Bacterial Proteins; Humans; Microbial Sensitivity Tests; Oxacillin; Staphylococcal Infections; Staphylococcus lugdunensis
PubMed: 34705537
DOI: 10.1128/JCM.03202-20 -
Cureus Apr 2018Infective endocarditis (IE) secondary to Staphylococcus lugdunensis has been increasingly recognized since 1988. IE-related thromboembolism represents an associated... (Review)
Review
Infective endocarditis (IE) secondary to Staphylococcus lugdunensis has been increasingly recognized since 1988. IE-related thromboembolism represents an associated complication of the disease and carries a dismal prognosis. However, the incidence of cerebrovascular accident secondary to S. lugdunensis IE is relatively uncommon and its treatment has not been clearly elucidated yet. We performed an extensive literature search using Pubmed, Medline, Scopus, and Google Scholar to identify the articles using the following keywords: 'Staphylococcus lugdunensis', 'infective endocarditis', 'stroke', and 'cerebrovascular accident.' Patient characteristics, risk factors, severity of neurological deficit, echocardiographic findings, medical management, required surgical intervention, complications and mortality rate were reviewed in detail. Eighteen cases (mean age of 47.8 years, 55% male) from 17 publications with S. lugdunensis-related cerebrovascular accident (CVA) were identified. Of these, 16 (87%) cases were left-sided endocarditis and 10 (61%) cases experienced right-sided neurological deficit. The source of infection was documented in eight cases (50%) in which four cases (50%) were related to groin-related procedures and the mitral valve (52.5%) was mostly infected followed by aortic valve (37%). Surgical valve replacement was done in 61% of patients and overall mortality rate was 22%. S. lugdunensis endocarditis is associated with high mortality and morbidity, including a higher prevalence of CVA. Early disease identification with aggressive intervention is crucial for better outcomes.
PubMed: 29900089
DOI: 10.7759/cureus.2469 -
Journal of Clinical Microbiology Nov 2017The implication of coagulase-negative staphylococci in human diseases is a major issue, particularly in hospital settings wherein these species often act as... (Review)
Review
The implication of coagulase-negative staphylococci in human diseases is a major issue, particularly in hospital settings wherein these species often act as opportunistic pathogens. In addition, some coagulase-negative staphylococci such as have emerged as pathogenic bacteria, implicated in severe infections, particularly, osteoarticular infections, foreign-body-associated infections, bacteremia, and endocarditis. studies have shown the presence of several putative virulence factors such as adhesion factors, biofilm production, and proteolytic factors that might explain clinical manifestations. Taken together, the clinical and microbiological data might change the way clinicians and microbiologists look at in clinical samples.
Topics: Humans; Staphylococcal Infections; Staphylococcus lugdunensis; Virulence Factors
PubMed: 28835477
DOI: 10.1128/JCM.00846-17