A multicenter international study on Staphylococcus lugdunensis infective endocarditis

Year: 2025

Type: conference-paper

Abstract: Background: Staphylococcus lugdunensis (SL) is an important cause of infective endocarditis (IE) with complications and mortality rates close to those of Staphylococcus aureus IE. The 2023 Duke-ISCVID criteria for IE added SL to the list of typical microorganisms, fulfilling a major criterion. Most reports on SLIE have been single-center and/or included a limited number of cases. We aimed to determine the contemporary characteristics of SLIE, and to identify the prognostic factors associated with in- hospital mortality. Methods: We included patients hospitalized with definite SLIE between 2010 and 2024. This was a collaborative study involving 17 centers in five countries (France, Spain, Brazil, Italy, and Ireland). Bacterial identification and antimicrobial susceptibility testing were performed using the automated VITEK 2 system, complemented or substituted by MALDI-TOF MS. Statistical analyses were conducted using Jamovi® (version 2.6.13). We performed a multivariate analysis for mortality-associated risk factors by a stepwise regression model including variables with a significance level <0.2 on univariate analysis. Results: One hundred and twelve patients with definite SLIE were included. Mean age was 67±18 years, and 76(67.9%) were male (table 1). Hospital-acquired SLIE accounted for 15.2% and healthcare-associated, non-hospital acquired for 16.1% of cases. Prosthetic valves were affected 36.6%, intracardiac devices 18.8%. Emboli occurred in 50% and heart failure during hospitalization in 32%. Other complications were acute kidney injury (39.4%) and perivalvular abscesses (20.5%). All strains were methicillin-susceptible, despite of the common healthcare-associated nature of SLIE (31.3%). Valve surgery was performed in 47(42%) and CIED removal in 10 (8.9%) patients. In-hospital mortality was 29.5%. Bivariate analysis is presented in Table 2. Five factors were associated with in-hospital mortality ( Table 3) : age at diagnosis (p<.001, OR 1.19 95%IC[1.08-1.31]), malignancy (p<.001, OR 26.22 95%IC[3.78-181.72]), a new severe mitral regurgitation (p= 0.002, OR 17.10 95%IC[2.81-104.09]), paravalvular abscess (p<.001, OR 63.40 95%IC[6.24-644.03]) and high degree atrioventricular block (p =0.007, OR 27.76 95%IC[2.49-309.82]). Conclusions: SLIE is an aggressive form of IE, frequently resulting in destructive lesions, indication for cardiac surgery, and death. Similarly to S. aureus IE, it is often healthcare-associated, resulting in severe complications and high mortality rate, despite all isolates being methicillin-susceptible.

Source: HAL AMU

Institutions: Centre Hospitalier Régional et Universitaire de Nancy, Interdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes – Région Est, Méditerranée Infection Foundation, Microbes Evolution Phylogénie et Infections, Hôpital de la Timone, Hôpital Saint-André, Centre Hospitalier Universitaire d'Angers, Centre Hospitalier Universitaire de Nantes, Université de Lorraine, Centre Hospitalier Universitaire de Rennes, Bacterial RNAs & Medicine, Hôpital Pontchaillou, Universitat Autònoma de Barcelona, Instituto de Salud Carlos III, Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires, Université de Picardie Jules Verne, Agents infectieux, résistance et chimiothérapie, Centre de Recherche en Cancérologie et Immunologie Intégrée Nantes Angers, Université d'Angers, Nantes Université, Mater Misericordiae University Hospital, University of Campania "Luigi Vanvitelli", Santobono Children's Hospital, Universidade de São Paulo

Language: English

Topic: Infective Endocarditis Diagnosis and Management

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

OpenAlex ID: W7205170043