LeuconostocSepticemia in a Preterm Neonate on Vancomycin Therapy: Case Report and Literature Review

Abstract

We report the case of a 26-day-old premature infant born at 24 weeks' gestation who developed septicemia while receiving vancomycin therapy. The blood isolate initially identified as a vancomycin-resistant Streptococcous viridans was found to be Leuconostoc spp. Her condition improved with parenteral ampicillin and gentamicin therapy and removal of the intravenous central catheter. Prematurity is a recognized risk factor for Leuconostoc disease. Clinicians need to consider Leuconostoc spp. when vancomycin-resistant pathogens are identified and provide appropriate therapy.

Catheter Related Leuconostoc Mesenteroides Bacteremia: A Rare Case and Review of the Literature

“…In another report, 35 percent of cases have polymicrobial etiology, so intra-abdominal source may be suspected (13). Moreover, Leuconostoc species are isolated from infant formula, various foods, gastric aspirates, gastrostomy tubes and these support the idea of gastrointestinal entry (15,18). Apart from that, a report by Bou et al (6) documents TPN as the source of nosocomial Leuconostoc infections.…”

“…Others speculate that gastrointestinal system is another entry site. They state that when the gastrointestinal system is colonized with Leuconostoc, translocation occurs (3,15,16). In another report, 35 percent of cases have polymicrobial etiology, so intra-abdominal source may be suspected (13).…”

“…However, some patients with Leuconostoc infection were immunocompetent (14). Other risk factors among published reports were gastrointestinal disease, prior vancomycin therapy, surgery distrupting gastrointestinal mucosal integrity, TPN usage, central venous line, prematurity (1,3,10,13,15).…”

A rarely seen cause for empyema: Leuconostoc mesenteroıdes

“…Bacteremia generally occur in patients hospitalized with significant underlying diseases or who had received previous antibiotic therapy. Premature birth and low birth weight are also risk factors for Leuconostoc sepsis [3,4]. In a high percentage of the patients from whom Leuconostoc was isolated; an underlined disease such as chronic renal failure, diabetes, pneumonia or chronic liver disease was reported [5].…”

Sepsis por Leuconostoc spp. en un lactante sano

“…4 La población pediátrica es especialmente vulnerable, sobre todo los recién nacidos prematuros, y los afectos de patología digestiva grave, como el síndrome de intesino corto. 5 De forma anecdótica se han descrito algunos casos en pacientes inmunocompetentes sin patología de base, especialmente lactantes sanos. a. UGC de Pediatría, Hospital General de Antequera, Málaga, España.…”