Lactobacillus rhamnosus Bacteremia in an Immunocompromised Renal Transplant Patient

Sendil, Selin; Shrimanker, Isha; Mansoora, Qurat; Goldman, John; Nookala, Vinod

doi:10.7759/cureus.6887

Cited by 10 publications

(14 citation statements)

References 15 publications

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“…Lactobacilli were isolated from blood [15,16,17,18,20,21,22,23,24,25,26,27,29,30,31,32,33,34,35,36,37,38,40,41,42,43,44,45,46,47,49,52,55,56,57], diseased valve tissue [28], abscess fluids [48,51,52,54,57,58], cerebrospinal fluid (CSF) [46], marrow [36], arthrocentesis aspiration fluid [53] in anaerobiosis and, in some cases, also in aerobiosis [40,15]. Use of automated microbial detection system, i.e.…”

Section: Cases Of Lactobacilli Infections Reported In Years 2019 2020...mentioning

confidence: 99%

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Lactobacilli Infection Case Reports in the Last Three Years and Safety Implications

Rossi¹,

Amadoro²,

Colavita³

2022

Preprint

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probiotics. However, these bacteria caused rare infections mostly in diabetic and immunocompromised subjects in presence of risk factors such as prosthetic hearth valves and dental procedures or caries. The scope of this survey was re-assessing the pathogenic potential of lactobacilli based on the infection case reports published in the last three years. In 2019, 2020 and 2021 17, 15 and 16 cases, respective-ly,.including endocarditis, bacteremia and other infections, were reported. These annual numbers are higher than observed previously. Lacticaseibacillus rhamnosus (13 cases), comprising strain GG (ATCC 53103) with established applications in healthcare, L. paracasei (7 cases), Lactobacillus acidophilus (5 cas-es), L. jensenii (5 cases), Lactiplantibacillus plantarum (3 cases), L. paraplantarum, L. delbrueckii subsp. del-brueckii, L. gasseri, L. paragasseri, Limosilactobacillus fermentum and L. reuteri (1 case each) were involved. Virulence characterization of two strains that caused infections, a derivative of L. rhamnosus GG and L.paracasei LP10266, indicated that increased biofilm forming capacity favors pathogenicity and it is determined by variable genetic traits. This survey highlighted that strains of lactobacilli able to cause infections were little characterized genet-ically. Instead, to avoid that these bacteria become a hazard, genetic stability should be periodically re-evaluated by whole genome sequencing (WGS) to ensure that only non-pathogenic variants are ad-ministered to vulnerable individuals.

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Section: Cases Of Lactobacilli Infections Reported In Years 2019 2020...mentioning

confidence: 99%

“…In two cases bacteremia was associated to localized infections, namely, liver abscess [21] and urinary tract infection (UTI) [23]. In the case reported by Sendil et al [35] bacteremia evolved to septic shock.…”

Section: Bacteremiamentioning

confidence: 99%

Lactobacilli Infection Case Reports in the Last Three Years and Safety Implications

Rossi¹,

Amadoro²,

Colavita³

2022

Preprint

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“…Of note, Lactobacillus infection after taking probiotics products contain Lactobacillus spp. had been reported in some relatively immunocompromised patients [ 63 , 64 , 65 ]. These immunocompromised patients were at higher risk of developing CDI, and the use of probiotics to prevent CDI in these group of patients should be approached more carefully.…”

Section: Probiotics Supply To Restore the Disturbed Microbiota In CDImentioning

confidence: 99%

Application of Microbiome Management in Therapy for Clostridioides difficile Infections: From Fecal Microbiota Transplantation to Probiotics to Microbiota-Preserving Antimicrobial Agents

et al. 2021

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Oral vancomycin and metronidazole, though they are the therapeutic choice for Clostridioides difficile infections (CDIs), also markedly disturb microbiota, leading to a prolonged loss of colonization resistance to C. difficile after therapy; as a result, their use is associated with a high treatment failure rate and high recurrent rate. An alternative for CDIs therapy contains the delivery of beneficial (probiotic) microorganisms into the intestinal tract to restore the microbial balance. Recently, mixture regimens containing Lactobacillus species, Saccharomyces boulardii, or Clostridium butyricum have been extensively studied for the prophylaxis of CDIs. Fecal microbiota transplantation (FMT), the transfer of (processed) fecal material from healthy donors to patients for treating CDIs, combined with vancomycin was recommended as the primary therapy for multiple recurrent CDIs (rCDIs). Either probiotics or FMT have been utilized extensively in preventing or treating CDIs, aiming at less disturbance in the microbiota to prevent rCDIs after therapy cessation. Otherwise, many newly developed therapeutic agents have been developed and aim to preserve microbiota during CDI treatment to prevent disease recurrence and might be useful in clinical patients with rCDIs in the future.

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“…Under certain circumstances and with the presence of certain risk factors, they can be the cause of severe infections including bacteremia and infective endocarditis (IE) [ 2 ], liver abscesses, peritonitis, pulmonary infections, pyelonephritis, and meningitis, among others [ 3 , 4 ]. Some of the main risk factors that have been described in Lactobacillus infections are diabetes mellitus (DM), structural heart disease [ 5 ], cancer (such as leukemia) [ 6 ], use of parenteral nutrition, use of broad-spectrum antibiotics, chronic kidney disease (CKD), neutropenia, solid-organ transplantation [ 7 ], chemotherapy, HIV and steroid use [ 3 ]. Predisposing factors like dental manipulations, poor dental hygiene, intravenous drug use, history of abdominal surgeries, and use of probiotics, are consistently reported [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Lactobacillus gasseri liver abscess and bacteremia: a case report

et al. 2021

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Background Lactobacillus is a genus of Gram-positive non-spore-forming rods usually found in the microbiota of the oral cavity, gastrointestinal tract, and female genitourinary tract. Also, they are commonly used in the food industry as supplements and probiotics. Lactobacilli are normally considered non-pathogenic to the human body, however, under certain circumstances such as immunosuppression, they can cause severe infections, with only a few cases of bacteremia, infective endocarditis, pneumonia, meningitis, and intra-abdominal infections reported. Among these presentations, a pyogenic liver abscess is rather rare. Case presentation We describe the case of a 59-year-old man with a history of diabetes mellitus and multiple abdominal surgeries with the latest being in 2014 presenting with bacteremia and multiple large pyogenic liver abscesses due to Lactobacillus gasseri, which did not appear to be related to the use of probiotics or immunosuppression. Conclusions Given the high prevalence of diabetes mellitus and the increased use of probiotics, it is expected that in the future we will see an increase in infections caused by Lactobacilli. Medical management with antibiotics and percutaneous drainage were successful strategies for the treatment of this unusual case of pyogenic liver abscesses and bacteremia caused by Lactobacillus gasseri.

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Lactobacillus rhamnosus Bacteremia in an Immunocompromised Renal Transplant Patient

Cited by 10 publications

References 15 publications

Lactobacilli Infection Case Reports in the Last Three Years and Safety Implications

Lactobacilli Infection Case Reports in the Last Three Years and Safety Implications

Application of Microbiome Management in Therapy for Clostridioides difficile Infections: From Fecal Microbiota Transplantation to Probiotics to Microbiota-Preserving Antimicrobial Agents

Lactobacillus gasseri liver abscess and bacteremia: a case report

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