Lactobacillus: the not so friendly bacteria

Abstract

We present a 65-year-old diabetic patient with a complex liver abscess and bacteraemia from The abscess resulted in a prolonged hospital stay due to ongoing sepsis despite ultrasound-guided drainage and broad-spectrum antibiotics. Furthermore, the patient developed several secondary complications including a right-sided pleural effusion, an inferior vena cava thrombus and septic lung emboli. The abscess was eventually managed successfully with a prolonged course of antibiotics and multiple ultrasound-guided drainage procedures.To our knowledge, this is the first reported case of probiotic consumption, confirmed by strain identification, as the likely source of a liver abscess. Probiotic products have been widely used for many years and are advocated to the general public for their health benefits with no warning of side effects. Lactobacilli are one group of bacteria commonly used in these products. Although rare, complications have been reported. Susceptible patients, such as those who are immunocompromised, should be advised against excessive consumption.

Gut Microbiota Composition Before and After Use of Proton Pump Inhibitors

“…It is generally considered that these bacteria have probiotic influences on human health [ 51 – 54 ]. However, there are several case reports demonstrating that lactobacilli caused serious infections such as bacteremia and liver abscesses in susceptible immunocompromised patients [ 55 , 56 ]. In addition to our results, increased numbers of Lactobacillus were also observed in patients with diseases such as diabetes mellitus type 2 [ 36 ] and Parkinson’s disease [ 57 ].…”

Major Traditional Probiotics: Comparative Genomic Analyses and Roles in Gut Microbiome of Eight Cohorts

“…However, reports of clinical infection or adverse effects, and the spread of antibiotic resistance genes, have raised concerns about safety. A case of an elderly diabetic patient with a complicated liver abscess and bacteremia from the consumption of Lactobacillus paracasei probiotic has been reported and confirmed by strain identification (Pararajasingam and Uwagwu, 2017). Probiotic therapy should be carefully selected in hemodialysis patients since probiotic supplements failed to reduce uremic toxins and inflammations (Borges et al, 2018).…”

Seven facts and five initiatives for gut microbiome research

“…In addition, in commercial activities there are cases of promoting probiotics towards immune-deficient populations, which is potentially risky (Cohen, 2018). In fact, special population including ICU patients (Yelin et al, 2019) and hospitalized elderly (Dauby, 2017) are at risk of bacteraemia when intake probiotics, and in extreme cases, immune-deficient elderly could develop hepatapostema and bacteraemia after long-term ingestion of yogurts (Pararajasingam and Uwagwu, 2017).…”