<i>Lactobacillus rhamnosus</i> bacteremia in a kidney transplant recipient

Falci, Diego Rodrigues; Rigatto, Maria Helena; Cantarelli, Vlademir Vicente; Zavascki, Alexandre Prehn

doi:10.1111/tid.12410

Cited by 12 publications

(7 citation statements)

References 17 publications

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“…Cases have been reported in transplant recipients and in patients with acute leukemia, uncontrolled diabetes mellitus, and chronic renal failure. 2 , 3 Other predisposing events and behaviors linked with Lactobacillus bacteremia include prolonged use of broad-spectrum antibiotics, dental manipulations and poor dental hygiene, as well as intravenous drug abuse. Use of probiotics has been reported as a potential source of Lactobacillus bacteremia in immunocompromised patients.…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus bacteremia: A tell-tale sign for diabetes?

LNU¹,

Abdelsalam²,

Bambach³

2022

Journal of Community Hospital Internal Medicine Perspectives

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Background Lactobacillus is a commensal that can be found as normal flora in the oropharynx, gastrointestinal and genitourinary tracts. Lactobacillus sepsis and bacteremia is usually found in immunocompromised individuals. In patients with no known underlying disease presenting with lactobacillus bacteremia, an extensive workup should be done before dismissing the organism as a contaminant. Case A 35-year-old man with no known past medical history presented with a perianal abscess associated with Lactobacillus bacteremia. There was no known history of human immunodeficiency virus, diabetes mellitus, carcinomas or chemotherapy, intravenous drug abuse, and/or commercial probiotic use. Laboratory testing revealed an HA1c of 15%, leading to a new diagnosis of diabetes mellitus and the initiation of insulin therapy. Conclusion Through this case report, we aim to raise awareness regarding underlying diseases that may be present when a patient presents with Lactobacillus bacteremia. The detection of Lactobacillus bacteremia should always prompt further investigation of its source and ensure clearance to prevent high mortality.

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Section: Discussionmentioning

confidence: 99%

Lactobacillus bacteremia: A tell-tale sign for diabetes?

LNU¹,

Abdelsalam²,

Bambach³

2022

Journal of Community Hospital Internal Medicine Perspectives

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“…To our knowledge, there are only two more case reports in the literature reporting primary bloodstream infection caused by Lactobacilli spp. in a kidney transplant recipient [12,13]. Vanichanan et al reported a 60-yearold renal transplant recipient who developed an intra-abdominal abscess which grew a carbapenem-resistant Lactobacillus casei (L. casei), with an uneventful follow-up course for four years.…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus rhamnosus Bacteremia in an Immunocompromised Renal Transplant Patient

Sendil

Shrimanker

Mansoora

et al. 2020

Cureus

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Conventionally, Lactobacillus species are considered as low virulence organisms and rarely cause infection in immunocompetent individuals. However, it might be an opportunistic infection source in immunocompromised patients and can cause invasive serious infections. To our knowledge, there are only a handful of cases in the literature reporting primary bloodstream infection caused by Lactobacilli spp. in transplant recipients. Here, we report a case of a kidney transplant recipient with Lactobacillus rhamnosus bacteremia.

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“…There is also a concern of the probiotic bacteria or fungus used in food production to translocate and cause systemic infections in immunocompromised transplant recipients. Available literature is limited to case reports or case series and use in circumstances where there may be an opportunity for translocation such as mucosal interruption or altered gastrointestinal blood supply during periods of hemodynamic instability 49‐51 . Most of the published literature demonstrates an association between exposure and this risk; however, there is potential for gene exchange and promotion of antibiotic resistance with use 51 .…”

Section: Over‐the‐counter Medicationsmentioning

confidence: 99%

Important considerations for drugs, nutritional, and herbal supplements in pediatric solid organ transplant recipients

Pilch

Sell

McGhee

et al. 2020

Pediatric Transplantation

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Pediatric transplant recipients are on multiple prescription and non‐prescription drugs. Many patients also use dietary, nutritional, and herbal supplements. This manuscript researched formulations of immunosuppressive drugs currently available and presents information on generic immunosuppressive drugs, commonly used non‐prescription medications, dietary supplements, and herbal supplements. Immunosuppressive drugs are available in various formulations. Not all formulations are interchangeable. A number of FDA‐approved generic formulations are available commercially in the United States. Generally generic formulations produce similar blood concentration vs time profiles compared to brand name products in adults and are considered to be bioequivalent. NSAID should be avoided in transplant patients due to potential drug interactions and increased risk associated with NSAID use; and appropriate doses of acetaminophen should be used for treatment of pain. Over‐the‐counter medications, such as guaifenesin and dextromethorphan, antihistamine medications, including diphenhydramine, loratadine, cetirizine, and fexofenadine, can be safely used in pediatric solid organ transplant population. Many safe and effective over‐the‐counter options exist for stool softening and as laxative. Diarrhea can lead to an increase in calcineurin inhibitor levels. Food can alter the absorption of immunosuppressive drugs. Several herbal products can alter immune status of the patients or alter the blood concentration of immunosuppressive drugs or may produce renal or hepatic toxicities and should be avoided in pediatric transplant recipients. It is important to educate pediatric transplant recipients and their families about not only immunosuppressive drug therapy but also about non‐prescription drugs, dietary, and herbal supplement use.

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Lactobacillus rhamnosus bacteremia in a kidney transplant recipient

Cited by 12 publications

References 17 publications

Lactobacillus bacteremia: A tell-tale sign for diabetes?

Lactobacillus bacteremia: A tell-tale sign for diabetes?

Lactobacillus rhamnosus Bacteremia in an Immunocompromised Renal Transplant Patient

Important considerations for drugs, nutritional, and herbal supplements in pediatric solid organ transplant recipients

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