Native and prosthetic transcatheter aortic valve infective endocarditis due to Lactobacillus rhamnosus

Bergas, A; Rivera, Samuel; Torrecillas, Miriam; Cuervo, Guillermo

doi:10.1016/j.eimc.2021.05.012

Cited by 2 publications

(4 citation statements)

References 17 publications

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“…detection in most laboratories is demanding given the problematic culture growth of the pathogen; only 30-50% of the isolates can be identified by conventional methods [69]. Thus, advanced molecular techniques such as 16S rRNA combined with MALDI-TOF MS are required for accurate identification [71,92].…”

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis by Lactobacillus Species—A Narrative Review

Ioannou,

Ziogou,

Giannakodimos

et al. 2024

Antibiotics

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Bacteria of the genus Lactobacillus are microaerophilic or aerotolerant anaerobic Gram-positive non-spore-forming rods. They are considered essential members of the human gut microbiome; however, recent studies have revealed that these microorganisms are less predominant in the gut microbiome than initially thought. Lactobacillus spp. is mainly known for its use as a probiotic in foods and supplements to prevent and treat specific issues such as infectious diseases, irritable bowel syndrome, and diabetes mellitus. However, Lactobacillus spp. may occasionally cause infections such as bacteremia or infective endocarditis (IE). The present study aimed to review all cases of IE by Lactobacillus spp. and describe the epidemiology, microbiology, clinical characteristics, treatment, and outcomes of this infection by collecting relevant data from studies existing in Pubmed and Scopus until 28 September 2023. A total of 77 studies containing data for 82 patients were included. The median age was 56 years, and 69.6% were male. A prosthetic valve was present in 16% of patients, and 17.3% had previously been on probiotics. The aortic valve was the most commonly involved intracardiac site, followed by the mitral valve. Fever, embolic phenomena, sepsis, and heart failure were the most common clinical presentations. Aminoglycosides and penicillin were the most commonly used antimicrobials for definitive treatment. Surgery was performed in 53.7% of patients. Overall mortality was 17.1%. IE in prosthetic valves and presentation with shock were independently associated with overall mortality.

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Section: Discussionmentioning

confidence: 99%

Infective Endocarditis by Lactobacillus Species—A Narrative Review

Ioannou,

Ziogou,

Giannakodimos

et al. 2024

Antibiotics

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“…Lactobacilli were isolated from blood [ 15 , 16 , 17 , 18 , 20 , 21 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 49 , 52 , 55 , 56 , 57 ], diseased valve tissue [ 23 ], abscess fluids [ 48 , 51 , 52 , 54 , 57 , 58 ], cerebrospinal fluid (CSF) [ 46 ], marrow [ 30 ], arthrocentesis aspiration fluid [ 53 ] in anaerobiosis and, in some cases, also in aerobiosis [ 15 , 34 ]. Use of automated microbial detection system, i.e., BACT/ALERT 3D or the BACTEC systems (BioMérieux) with incubation at 35 °C were mentioned in some reports [ 23 , 31 , 34 ]. The case reports that described the identification procedures mostly referred to standardized instrumental techniqu...…”

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

confidence: 99%

“…Susceptibility to β-lactams, including amoxicillin, amoxicillin/clavulanic acid, ampicillin, ampicillin-sulbactam, benzylpenicillin, penicillin G, piperacillin/tazobactam, and meropenem IV was reported in most cases. These antibiotics were used singly or in association with gentamicin, clindamycin, and clarithromycin [ 16 , 17 , 20 , 21 , 22 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 35 , 36 , 37 , 38 , 39 , 40 , 43 , 44 , 45 , 46 , 48 , 49 , 51 , 53 , 54 , 55 , 56 , 57 , 58 ].…”

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

confidence: 99%

“…Most of the cases of endocarditis had a deceitful and slow onset, with or without fever, with symptoms varying among patients and including weight loss, fatigue, dyspnea, cough, chills, sweats, abdominal pain with nausea and vomiting, lumbar pain, syncope, with valvular vegetations becoming detectable after many days or even months from the beginning of symptoms [ 14 , 15 , 16 , 17 , 18 , 20 , 22 , 23 , 27 , 29 , 30 , 31 , 32 , 34 ]. In many cases replacement of the aortic valve [ 15 , 16 , 17 , 18 , 20 , 21 , 26 , 28 , 30 , 35 ], in one case replacement of the mitral valve [ 25 ], and in another case replacement of both aortic and mitral valves [ 23 ] were necessary.…”

Section: Aspects Of the Lactobacilli Infections Casesmentioning

confidence: 99%

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

et al. 2022

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Lactobacilli constitute the dominant microbiota in many fermented foods and comprise widely used probiotics. However, these bacteria cause 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, total of 17, 15, and 16 cases, respectively, including endocarditis, bacteremia, and other infections, were reported. These annual numbers are higher than those observed previously. Lacticaseibacillus rhamnosus (13 cases), comprising strain GG (ATCC 53103) with established applications in healthcare, L. paracasei (7 cases), Lactobacillus acidophilus (5 cases), L. jensenii (5 cases), Lactiplantibacillus plantarum (3 cases), L. paraplantarum, L. delbrueckii subsp. delbrueckii, 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 highlights that the strains of lactobacilli that cause infections are little characterized genetically. 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 administered to vulnerable individuals.

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Native and prosthetic transcatheter aortic valve infective endocarditis due to Lactobacillus rhamnosus

Cited by 2 publications

References 17 publications

Infective Endocarditis by Lactobacillus Species—A Narrative Review

Infective Endocarditis by Lactobacillus Species—A Narrative Review

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

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