Department of Dermatology, Rambam Health Care Campus, Technion, Haifa, Israel.
Clinical Microbiology Laboratory, Rambam Health Care Campus, Technion, Haifa, Israel.
J Dermatol. 2018 Aug;45(8):994-999. doi: 10.1111/1346-8138.14496. Epub 2018 Jun 13.
Staphylococcus lugdunensis is an emerging pathogen in skin and soft tissue infections that was previously considered a commensal. The aim of this study was to elucidate the characteristics of skin infections by S. lugdunensis and its appropriate management, in a tertiary referral medical center. The clinical files, bacterial cultures and histopathology reports of all S. lugdunensis isolates from skin infections over a period of 8 years (September 2009-September 2017) were reviewed. S. lugdunensis was isolated from 29 patients with skin infections, aged 7-89 years (mean 33.3 years). A state of immune suppression (drug-induced, malignancy or diabetes) was present in five patients (17%). Folliculitis and cutaneous pustulosis were the most common presentations (16 cases, 55%), followed by secondary infection of hidradenitis suppurativa (five cases, 17%). Other sources of isolation were infected molluscum contagiosum (two cases), folliculitis decalvans (one case), dissecting cellulitis (one case), abscess (one case), cyst (one case), impetigo (one case) and granuloma after trauma (one case). The in vitro antibiotic sensitivity tests showed susceptibility to most tested antibiotics, although a few isolates were resistant to gentamycin, penicillin and oxacillin. In 19 of 20 patients for whom follow ups were available, cutaneous manifestations improved or resolved with proper local and/or oral antibiotic therapy. S. lugdunensis may play a role as a primary or secondary pathogen in various skin infections, most commonly folliculitis and pustulosis. Proper antibiotic therapy may lead to improvement or resolution.
路邓葡萄球菌是一种新出现的皮肤和软组织感染病原体，以前被认为是一种共生菌。本研究旨在阐明路邓葡萄球菌引起的皮肤感染的特征及其在三级转诊医疗中心的适当处理方法。回顾了 8 年间（2009 年 9 月至 2017 年 9 月）所有路邓葡萄球菌皮肤感染的临床病历、细菌培养和组织病理学报告。从 29 例皮肤感染患者中分离出路邓葡萄球菌，年龄 7-89 岁（平均 33.3 岁）。5 例患者（17%）存在免疫抑制状态（药物诱导、恶性肿瘤或糖尿病）。最常见的表现为毛囊炎和皮肤脓疱病（16 例，55%），其次为化脓性汗腺炎的继发感染（5 例，17%）。其他分离源包括感染性传染性软疣（2 例）、脱发性毛囊炎（1 例）、分离性蜂窝织炎（1 例）、脓肿（1 例）、囊肿（1 例）、脓疱疮（1 例）和创伤后肉芽肿（1 例）。体外抗生素药敏试验显示，大多数受试抗生素均敏感，但少数分离株对庆大霉素、青霉素和苯唑西林耐药。在 20 例可获得随访的患者中，19 例患者的皮肤表现通过适当的局部和/或口服抗生素治疗得到改善或消退。路邓葡萄球菌可作为原发性或继发性病原体引起各种皮肤感染，最常见的是毛囊炎和脓疱病。适当的抗生素治疗可能会改善或消退。
