Staphylococcus lugdunensis , a Not So Infrequent Pathogen in Orthopedic Surgery.

Abstract Background: Staphylococcus lugdunensis is a coagulase-negative staphylococci that is considered normal skin microbiota. It has been described as a cause of soft tissue infections but is not a common micro-organism as the cause of orthopedic surgery-related infections. This study describes the characteristics, treatment, and results of musculoskeletal infection by Staphylococcus lugdunensis treated in our institution. Methods: We performed a descriptive, retrospective observational study. Clinical records of all musculoskeletal infections treated in our department between 2012 and 2020 were reviewed. We selected those patients with a positive monomicrobial culture for Staphylococcus lugdunensis . Risk factors for infection, patient's medical records, previous surgery performed, time from surgery to infection, culture antibiogram, antibiotic and surgical treatment for the infection, and recovery rate were registered for the analysis. Results: Of the 1,482 patients with musculoskeletal infections diagnosed in our institution, 22 had a monomicrobial positive culture of Staphylococcus lugdunensis after an orthopedic surgery representing 1.5% of all orthopedic infections. Ten patients underwent arthroplasty, six underwent fractures synthesis, three had foot surgeries, two had anterior cruciate ligament reconstructions, and one had spine surgery. All patients needed surgery and antibiotic treatment with a mean of two surgeries. The most used antibiotic scheme was levofloxacin-rifampicin. The mean follow-up was 36 months. Ninety-six percent of the patients achieved a complete clinical and analytical recovery. Conclusions: Although musculoskeletal infections caused by Staphylococcus lugdunensis are not common, we have observed a statistically significant incidence increase of Staphylococcus lugdunensis in recent years. If managed with appropriately aggressive surgical treatment and correct antibiotic therapy, good results can be obtained.