<i>Lactobacillus rhamnosus</i>
            Meningitis following Recurrent Episodes of Bacteremia in a Child Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Robin, Frédéric; Paillard, Catherine; Marchandin, Hélène; Deméocq, F.; Bonnet, Richard; Hennequin, Claire

doi:10.1128/jcm.00250-10

Cited by 60 publications

(42 citation statements)

References 16 publications

(19 reference statements)

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“…It is thus possible that these organisms were misidentified and that, similar to what was observed in our study, L. rhamnosus and L. gasseri were more commonly isolated. The pathogenicity of L. rhamnosus has been confirmed by other reports (2,7,8,27), particularly in association with respiratory infections (28). In addition, the Gram staining of lactobacilli from the original specimen can be confusing; several of our specimens were interpreted as Gram-positive cocci in chains and possible rods.…”

Section: Discussionsupporting

confidence: 64%

Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

et al. 2014

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Veterans Administration Puget Sound Health Care System, Seattle, Washington, USA c Lactobacillus spp. are part of the normal human flora and are generally assumed to be nonpathogenic. We determined the genotypic identification of >100 Lactobacillus isolates from clinical specimens in the context of presumed pathogenic potential (e.g., recovered as the single/predominant isolate from a sterile site or at >10 5 CFU/ml from urine). This study assessed the clinical significance and the frequency of occurrence of each Lactobacillus sp. We identified 16 species of Lactobacillus by 16S rRNA gene sequence analysis, 10 of which could not be associated with disease. While Lactobacillus rhamnosus, Lactobacillus gasseri, and Lactobacillus paracasei were associated with infections, L. gasseri was also a common colonizing/contaminating species. Lactobacillus casei, Lactobacillus johnsonii, and Lactobacillus delbrueckii were associated with at least one infection. Species commonly used in probiotic products (e.g., L. rhamnosus and L. casei) were identical, by 16S rRNA gene sequencing, to our isolates associated with disease. Human isolates of Lactobacillus spp. have differing site associations and levels of clinical significance. Knowing the niche and pathogenic potential of each Lactobacillus sp. can be of importance to both clinical microbiology and the food and probiotic supplement industry.

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Section: Discussionsupporting

confidence: 64%

Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

et al. 2014

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“…Although probiotic usage has been shown to be safe in a variety of other clinical settings, 12,13,16,26,27 several case reports suggest that the probiotic itself may have caused bacteremia in the setting of HCT. [30][31][32] Our results suggest that LBP administration is both safe and feasible. In contrast to the published case reports, we are assured that the probiotic used for this study was free from contamination and maintained viable colony-forming units throughout the study period.…”

Section: Discussionmentioning

confidence: 58%

The safety and feasibility of probiotics in children and adolescents undergoing hematopoietic cell transplantation

Ladas

Bhatia

Chen

et al. 2015

Bone Marrow Transplant

106

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Hematopoietic cell transplantation (HCT) has become a standard treatment for many adult and pediatric conditions. Emerging evidence suggests that perturbations in the microbiota diversity increase recipients' susceptibilities to gut-mediated conditions such as diarrhea, infection and acute GvHD. Probiotics preserve the microbiota and may minimize the risk of developing a gutmediated condition; however, their safety has not been evaluated in the setting of HCT. We evaluated the safety and feasibility of the probiotic, Lactobacillus plantarum (LBP), in children and adolescents undergoing allogeneic HCT. Participants received oncedaily supplementation with LBP beginning on day − 8 or − 7 and continued until day +14. Outcomes were compliance with daily administration and incidence of LBP bacteremia. Administration of LBP was feasible with 97% (30/31, 95% confidence interval (CI) 83-100%) of children receiving at least 50% of the probiotic dose (median 97%; range 50-100%). We did not observe any case of LBP bacteremia (0% (0/30) with 95% CI 0-12%). There were not any unexpected adverse events related to LBP. Our study provides preliminary evidence that administration of LBP is safe and feasible in children and adolescents undergoing HCT. Future steps include the conduct of an approved randomized, controlled trial through Children's Oncology Group.

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“…Lactobacillus rarely causes disease in humans, owing to its low virulence; however, the organism can cause bacteremia, endocarditis, intra-abdominal abscess, surgical site infections, endometritis, urinary tract infections, and meningitis especially in patients with severe underlying comorbidity or suppressed immune systems [1][2][3][4][5][6]. Various classes of antibiotics have activity against Lactobacillus but strains resistant to multiple antibiotics have been reported [7,8].…”

Section: Introductionmentioning

confidence: 97%

Carbapenem-resistant Lactobacillus intra-abdominal infection in a renal transplant recipient with a history of probiotic consumption

et al. 2016

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Here, we report a case of a 60-year-old renal transplant recipient who developed an intra-abdominal abscess which grew a carbapenem-resistant Lactobacillus casei. This is significant since it is the first report of a clinical isolate of Lactobacillus sp. that demonstrated both microbiological and clinical resistance to carbapenem use. Moreover, the probiotic supplement that the patient had taken also grew a similar organism raising the concern of probiotic associated infection in immunocompromised individual.

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Lactobacillus rhamnosus Meningitis following Recurrent Episodes of Bacteremia in a Child Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

Cited by 60 publications

References 16 publications

Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

The safety and feasibility of probiotics in children and adolescents undergoing hematopoietic cell transplantation

Carbapenem-resistant Lactobacillus intra-abdominal infection in a renal transplant recipient with a history of probiotic consumption

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