Bacteremia after Bacillus clausii administration for the treatment of acute diarrhea: A case report

Abstract

Bacillus clausii is a gram-positive rod used as a probiotic to treat diarrhea and the side effects of antibiotics such as pseudomembranous colitis. We report a case of B. clausii bacteremia in a non-immunocompromised patient with active peptic ulcer disease and acute diarrhea. The probiotic was administered during the patient´s hospitalization due to diarrhea of infectious origin. B. clausii was identified in the bloodstream of the patient through Matrix-Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF), days after her discharge. Given the wide use of probiotics, we alert clinicians to consider this microorganism as a causative agent when signs of systemic infection, metabolic compromise, hemodynamic instability establish after its administration and there has not been any identified pathogens that could explain the clinical course.

Bacillus clausii Bacteremia After Probiotic Usage in a Pediatric Patient

“…6 Although bacteremia and other systemic infections due to B. clausii have been shown to be exceptional, it should be kept in mind that it might cause some adverse events rather than benefit in some patients. 1,7 In the literature, bacteremia due to B. clausii was reported in 7 cases until today, 2 of which were children (Table 1). 1,3,[7][8][9] It is noteworthy that bacteremia was reported in patients who were immunocompetent as well as in patients with underlying immunosuppressive states.…”

Update of the list of QPS‐recommended microbiological agents intentionally added to food or feed as notified to EFSA 16: suitability of taxonomic units notified to EFSA until March 2022

“…One paper (D'Agostin et al., 2021) reviewed human case reports related to probiotic intake of B. clausii which were already discussed in previous EFSA statements. Four papers had methodology problems related to the identification methodology used (Garcia et al., 2021 ; Severiche‐Bueno et al., 2021 ; Lampropoulos et al., 2021 ) and/or the source attribution (Konate et al., 2021 ; Severiche‐Bueno et al., 2021). Three papers described predisposing factors for the infection (Garcia et al., 2021; Konate et al., 2021; Lampropoulos et al., 2021).…”

“…Four papers had methodology problems related to the identification methodology used (Garcia et al, 2021; and/or the source attribution (Konate et al, 2021;. Three papers described predisposing factors for the infection (Garcia et al, 2021;Konate et al, 2021;. One paper presented phylogenetic and phylogenomic results based on the genome sequences of 96 B. amyloliquefaciens strains from different sources, mentioning the presence of possible virulence genes in strains.…”

Bacillus clausii for Gastrointestinal Disorders: A Narrative Literature Review

“…An isolated case of B. clausii septicemia was reported in a very young (4-month-old) patient with congenital heart disease being treated for diarrhea; Klebsiella pneumoniae was also detected in a blood culture from this patient [ 95 ]. Administration errors and bacterial translocation have been suggested as potential causes of bacteremia [ 96 ], and the presence of GI bleeding may increase the risk of translocation; in one case, an individual with active peptic ulcer disease developed bacteremia after receiving B. clausii as part of inpatient treatment for infectious diarrhea [ 97 ]. Care should therefore be taken when considering prolonged administration of probiotic preparations to individuals with underlying comorbidities who may be at risk of developing bacteremia.…”