Staphylococcus pseudintermedius Bacteremia in a Lung Transplant Recipient Exposed to Domestic Pets

Small, Coulter; Beatty, Norman; El Helou, Guy

Staphylococcus pseudintermedius commonly colonizes companion animals, including canines. This microbe is a major opportunistic pathogen responsible for pyogenic and necrotizing skin and soft tissue infection in canines. Infection with S. pseudintermedius is increasingly being recognized in humans, especially in those who are immunocompromised. This microbe is quite similar to Staphylococcus aureus, expressing several analogous virulence factors and a variety of toxins. Furthermore, S. pseudintermedius has variants that display multi-drug resistance comparable to methicillin-resistant S. aureus. We report a 50-year-old female with bilateral lung transplant on immunosuppression who presents with signs of sepsis and pneumonia. Initial blood cultures grew Gram-positive cocci that were not initially identified via molecular diagnostics as Staphylococcus species but were later confirmed as S. pseudintermedius through mass spectrometry. Antimicrobial susceptibility testing demonstrated multi-drug resistance, including methicillin. Despite aggressive medical and antimicrobial treatment, our patients succumbed to the infection. The source of infection likely came from her companion canine at home as no other source could be identified; however, cultures were unable to be obtained from the companion canine. Those who are immunosuppressed, such as with solid organ transplants, should take caution with exposure to companion animals due to the potential for S. pseudintermedius infection.