The blood infection rate of S. lugdunensis is around 0.3% [9], which is lower than most other bacteria. However, there are an increasing number of Sapanisertib reports on blood infections caused by this bacterium [10, 11]. The prevalence of S. lugdunensis varies greatly among different geographical

regions, including 1.3% in Japan [12], 0.8% in Korea [13], 3% in the U.S. [14], and 6% in Argentina [15]. While it is suspected that the incidence of this bacterium in Asiatic countries is similar, its incidence has not yet been investigated in China. One reason for the low PF-2341066 detection and underappreciated infection rates of S. lugdunensis are that most clinical microbiology laboratories do not usually speciate CoNS [7, 16]. Therefore, accurate methods are needed in order to accurately determine incidence by speciation of CoNS isolates. While Frank et al. suggested that ornithine decarboxylase (ODC) and pyrrolidonyl arylamidase (PYR) tests could identify S. lugdunensis from CoNS [17], Tan et al. showed that these two tests could only be used as a preliminarily screen for the bacterium PD0332991 [18]. Currently, it is believed that the sequence of the glyceraldehyde-3-phosphate dehydrogenase-encoding (gap) gene can be used to accurately identify S. lugdunensis[19]. Additionally, the current problem of drug resistance in CoNS

isolates is severe [20]. The rate of drug resistance of S. lugdunensis varies throughout the world and while it is susceptible to most antibiotics, there are case reports on its resistance to Dimethyl sulfoxide some drugs [17, 18, 21, 22]. The objectives of the present study were to determine the frequency of S. lugdunensis in 670 non-replicate CoNS clinical isolates from the General Hospital of the People’s Liberation Army in China and to clinically and microbiologically characterize

them. Specifically, we determined drug resistance patterns and molecular epidemiological characteristics, contributing to the clinical diagnosis and treatment of S. lugdunensis infections. Results Detection of S. lugdunensis isolates Eight out of the 670 isolates were positive for both ODC and PYR (single positives were not pursued further). Isolate 2 and 4 were positive in the Latex Agglutination test; however, only Isolate 4 was positive in the Slide Coagulase test. All isolates were negative in the subsequent Tube Coagulase test. Of these eight isolates, 4 were further validated by both VITEK 2 GP and API 20 Staph, with a sensitivity of 80% (4/5), one could not be accurately identified by either, and the other 3 were identified as S. haemolyticus (Table 1). The sequences of the gap gene for all 5 isolates were 99% identical to the corresponding S. lugdunensis sequence (GenBank accession number AF495494.1) (Figure 1). Hence, five out of the 670 CNS isolates were detected as being S. lugdunensis, a detection rate of 0.7% (5/670). Of the of five S.