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Staphylococcus lugdunensis (S. lugdunensis) is a coagulase-negative staphylococcus species (CoNS) that has been increasingly recognised to cause serious infections with virulence resembling staphylococcus aureus (S. aureus). S. lugdunensis have been shown to cause a variety of infections such as infective endocarditis. However, no studies have evaluated the characteristics and outcomes of patients with S. lugdunensis peritoneal dialysis related peritonitis compared those with S. aureus peritonitis.
We retrospectively reviewed the clinical and laboratory characteristics of all patients with S. aureus and S. lugdunensis peritonitis in our tertiary centre between July 2000 and July 2020. The cases were individually matched for year of the peritonitis, gender, age (±10 years) and Charlson Comorbidity index (±3). A comparative analysis was performed between the two organisms.
48 episodes of S. aureus peritonitis were matched to 19 cases of S. lugdunensis peritonitis. There is a higher predilection of diabetes in those with S. aureus peritonitis than those with S. lugdunensis (64.6% vs 31.6%; p=0.03). Patients with S. aureus peritonitis also have a much higher total cells count at presentation (4463.9 ± 5479.5 vs 1807.9 ± 3322.7; p=0.05); a higher prevalence of treatment failure (50.0% vs 16.7%; p=0.02); and are more prone to relapse with the same organism (29.2% vs 0% respectively; p=0.01) as compared to those with S. lugdunensis.
Although S. aureus peritonitis is more virulent with significant morbidity, S. lugdunensis can cause similarly serious peritonitis and should not be regarded as harmless unlike other CoNS. This largest cases series of S. lugdunensis peritonitis enabled better characterisation in the clinical features and outcomes of patients with S. lugdunensis peritonitis.