Lactobacillus endocarditis: A case report in France and literature review

Campagne, J.; Guichard, Jack; Moulhade, Marie Christine; Kawski, H.; Maurier, F.

doi:10.1016/j.idcr.2020.e00811

Cited by 27 publications

(39 citation statements)

References 42 publications

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“…However, it has been challenging to elucidate the explicit mechanisms underlying this translocation. Previous studies showed that a large number of patients (64%) were valvulopathy, while ~ 30% of patients had dental procedures or invasive procedures and immunosuppression was only accounted for nearly 20% [ 27 ]. The history of cardiac disease and inguinal hernia repair might be the potential risk factors for endocarditis of the patient in our study.…”

Section: Discussionmentioning

confidence: 99%

Characterization of a bacterial strain Lactobacillus paracasei LP10266 recovered from an endocarditis patient in Shandong, China

et al. 2021

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Background Lactobacilli are often recognized as beneficial partners in human microbial environments. However, lactobacilli also cause diseases in human, e.g. infective endocarditis (IE), septicaemia, rheumatic vascular disease, and dental caries. Therefore, the identification of potential pathogenic traits associated with lactobacilli will facilitate the prevention and treatment of the diseases caused by lactobacilli. Herein, we investigated the genomic traits and pathogenic potential of a novel bacterial strain Lactobacillus paracasei LP10266 which has caused a case of IE. We isolated L. paracasei LP10266 from an IE patient’s blood to perform high-throughput sequencing and compared the genome of strain LP10266 with those of closely related lactobacilli to determine genes associated with its infectivity. We performed the antimicrobial susceptibility testing on strain LP10266. We assessed its virulence by mouse lethality and serum bactericidal assays as well as its serum complement- and platelet-activating ability. The biofilm formation and adherence of strain LP10266 were also studied. Results Phylogenetic analysis revealed that strain LP10266 was allied with L. casei and L. paracasei. Genomic studies revealed two spaCBA pilus clusters and one novel exopolysaccharides (EPS) cluster in strain LP10266, which was sensitive to ampicillin, penicillin, levofloxacin, and imipenem, but resistant to cefuroxime, cefazolin, cefotaxime, meropenem, and vancomycin. Strain LP10266 was nonfatal and sensitive to serum, capable of activating complement 3a and terminal complement complex C5b-9 (TCC). Strain LP10266 could not induce platelet aggregation but displayed a stronger biofilm formation ability and adherence to human vascular endothelial cells (HUVECs) compared to the standard control strain L. paracasei ATCC25302. Conclusion The genome of a novel bacterial strain L. paracasei LP10266 was sequenced. Our results based on various types of assays consistently revealed that L. paracasei LP10266 was a potential pathogen to patients with a history of cardiac disease and inguinal hernia repair. Strain LP10266 showed strong biofilm formation ability and adherence, enhancing the awareness of L. paracasei infections.

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Section: Discussionmentioning

confidence: 99%

Characterization of a bacterial strain Lactobacillus paracasei LP10266 recovered from an endocarditis patient in Shandong, China

et al. 2021

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“…Fifty cases of Lactobacillus endocarditis (LE) have been reported in literature [11] , [12] , [13] , [14] , [15] , [16] and only six cases of L. jensenii , including our case, have been described thus far (MEDLINE 01.2020). Lactobacilli produce lactic acid as a major end-product of carbohydrate fermentation and have been used for centuries in the food industry [2] .…”

Section: Discussionmentioning

confidence: 94%

“…Our patient developed transient renal failure under aminoglycosides treatment and had a favourable outcome on β-lactam monotherapy, most probably favoured by the reduction in bacterial inoculum after valvular replacement surgery and a thrombectomy. In fact, valvular surgery is often necessary in the treatment of Lactobacillus endocarditis and is described in about half of the cases reported in literature [1] , [8] , [12] . The use of a MBC/MIC ratio has also been suggested to guide antibiotic treatment.…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus jensenii mitral valve endocarditis: Case report, literature review and new perspectives

Gauthier

Rigamonti

Leo³

et al. 2022

IDCases

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Lactobacillus is a facultative anaerobic Gram-positive rod usually found in the normal microbiota of the gastrointestinal and genitourinary tract. Frequently dismissed as a contaminant, it is implicated in several diseases. We describe a rare case of endocarditis caused by Lactobacillus jensenii in an immunocompetent 40 year-old male patient , with a history of mitral valve repair. He presented complaining of asthenia and his laboratory results showed a moderate increase in inflammatory markers. A trans-thoracic echocardiography confirmed a vegetation on the posterior leaflet of the mitral valve, with associated severe mitral insufficiency. Blood cultures revealed the significant growth of L. jensenii. The patient developed an acute abdomen with intestinal ischemia and occlusion of the superior mesenteric artery, requiring urgent surgical laparotomy. A cerebral MRI showed multiple minor emboli in the frontal and left parietal cortex. The patient consequently underwent surgery to have his mitral valve replaced with a mechanical valve. L. jensenii was isolated in culture from the mitral valve and from a mesenteric artery thrombus. After one week of combined amoxicillin and gentamicin therapy, ampicillin alone was continued for a total of six weeks and the patient could be discharged in a good general condition. Only five cases of L. jensenii are described in literature, and they mainly affect immunocompromised hosts. In our case, a long delay between the start of symptoms and the full onset of the disease was observed. tolerance of Lactobacilli to penicillin is a key determinant of therapy choice.

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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%

“…Susceptility 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 [16,17,20,21,22,23,24,25,26,27,31,32,33,34,36,37,38,41,43,44,45,46,48,49,51,53,54,55,56,57,58] .…”

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

confidence: 99%

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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Lactobacillus endocarditis: A case report in France and literature review

Cited by 27 publications

References 42 publications

Characterization of a bacterial strain Lactobacillus paracasei LP10266 recovered from an endocarditis patient in Shandong, China

Characterization of a bacterial strain Lactobacillus paracasei LP10266 recovered from an endocarditis patient in Shandong, China

Lactobacillus jensenii mitral valve endocarditis: Case report, literature review and new perspectives

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

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