# Clinical Disease and Outcomes of Invasive Staphylococcus lugdunensis Infection in a University Hospital in Saudi Arabia

## TL;DR

This study examines Staphylococcus lugdunensis infections in Saudi Arabia, finding that most cases are community-acquired and that patients with more comorbidities face higher mortality.

## Contribution

The first study in Saudi Arabia to report clinical outcomes and antibiotic susceptibility patterns of Staphylococcus lugdunensis infections.

## Key findings

- Most S. lugdunensis infections were community-acquired and cultured from wound swabs.
- Vancomycin showed 100% susceptibility, while oxacillin, clindamycin, and trimethoprim-sulfamethoxazole had lower rates.
- Higher Charlson comorbidity index was significantly associated with 30-day mortality.

## Abstract

Background

Staphylococcus lugdunensis is a pathogen that can cause various diseases in humans, of which bacteremia and infective endocarditis have been described most extensively. In Saudi Arabia, reports of S. lugdunensis infection are extremely rare, and no studies have reported S. lugdunensis antibiotic susceptibility. The objective of this study was to determine S. lugdunensis clinical disease, potential risk factors, susceptibility pattern, and 30-day mortality.

Methods

A retrospective study was performed at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, from January 1, 2015, to December 31, 2022. Patients ≥14 years old were included. All variables, such as age, sex, body mass index (BMI), clinical manifestations, source of infection, antimicrobial susceptibility, antimicrobial given, duration of treatment, and 30-day mortality, were obtained from electronic health charts.

Results

Twenty-five patients with S. lugdunensis infection were identified, with a median age of 58 years and all had comorbidities (mean: 2, range 1-10). The patients had a median BMI of 28, and most patients were either overweight (28%, n = 7) or obese (48%, n = 12). The 30-day mortality was only 8% (n = 2). S. lugdunensis was most often cultured from wound swabs (72%, n = 18) and blood (20%, n = 5). The majority (68%, n = 17) of infections were community-acquired. Antibiotic susceptibility to vancomycin was 100% (n = 25), oxacillin 72% (n = 18), and clindamycin and trimethoprim-sulfamethoxazole 64% (n = 16) each. The mean Charlson comorbidity index was significantly higher (p-value = 0.027) among the deceased patients (6.00 ± 2.12) than those that survived (1.83 ± 1.77).

Conclusion

S. lugdunensis can cause clinically significant disease, especially in patients with multiple comorbidities, and a higher Charlson comorbidity index was found in patients who died.