Lactobacillus gasseri as the cause of septic urinary infection

Dickgiesser, U; Weiss, Norbert; Fritsche, D

doi:10.1007/bf01641017

Cited by 36 publications

(23 citation statements)

References 16 publications

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“…Recent studies showed that the urine microbiota consists mainly of lactobacilli (29,30); therefore, the organisms isolated from UG samples in this study likely represent commensal organisms. However, Lactobacillus has been associated with urinary infections in the literature (31) and was associated with a UTI with obstruction in one of our patients (L. rhamnosus in the urine of a male patient). A limitation of our study is that it was conducted within a primarily adult male population.…”

Section: Discussionmentioning

confidence: 69%

Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

et al. 2014

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Veterans Administration Puget Sound Health Care System, Seattle, Washington, USA c Lactobacillus spp. are part of the normal human flora and are generally assumed to be nonpathogenic. We determined the genotypic identification of >100 Lactobacillus isolates from clinical specimens in the context of presumed pathogenic potential (e.g., recovered as the single/predominant isolate from a sterile site or at >10 5 CFU/ml from urine). This study assessed the clinical significance and the frequency of occurrence of each Lactobacillus sp. We identified 16 species of Lactobacillus by 16S rRNA gene sequence analysis, 10 of which could not be associated with disease. While Lactobacillus rhamnosus, Lactobacillus gasseri, and Lactobacillus paracasei were associated with infections, L. gasseri was also a common colonizing/contaminating species. Lactobacillus casei, Lactobacillus johnsonii, and Lactobacillus delbrueckii were associated with at least one infection. Species commonly used in probiotic products (e.g., L. rhamnosus and L. casei) were identical, by 16S rRNA gene sequencing, to our isolates associated with disease. Human isolates of Lactobacillus spp. have differing site associations and levels of clinical significance. Knowing the niche and pathogenic potential of each Lactobacillus sp. can be of importance to both clinical microbiology and the food and probiotic supplement industry.

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Section: Discussionmentioning

confidence: 69%

Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

et al. 2014

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“…Our review of the literature revealed only one previously published case report of a 66-year-old diabetic male who developed acute renal failure and sepsis in a setting of ureteral obstruction. The patient's urine and blood yielded pure cultures of Lactobacillus gasseri, and following treatment with amoxicillin, the patient recovered fully (3).…”

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confidence: 95%

Lactobacillus delbrueckii as the Cause of Urinary Tract Infection

2009

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Lactobacilli are part of the normal bacterial flora of the vagina and are typically considered contaminants when cultured from urine specimens of female patients. Here we describe the case of a female patient with chronic pyuria and urinary tract symptoms in which Lactobacillus delbrueckii was determined to be the causative microorganism. CASE REPORTAn 85-year-old female with recurrent urinary tract infections called her gynecologist reporting painful urination, frequency, and urgency. A prescription for ciprofloxacin at 250 mg twice a day (BID) for 7 days (adjusted for a decreased glomerular filtration rate) was called in to her local pharmacy. She experienced no relief of symptoms with this treatment.Two weeks later, she was seen in the clinic. She denied fevers or flank pain but continued to have urgency, dysuria, and a frequency of every 1.5 h, including nocturia. Her further pertinent medical and surgical history included a stage III cystocele, vaginal prolapse repair in 1999, total abdominal hysterectomy with bilateral salpingoopherectomy in 1962, hypothyroidism, and two prior discectomies. She intermittently applied vaginal estradiol. She had not used pessaries for her vaginal prolapse in 9 years and had no recent indwelling Foley catheter or intermittent self-catheterization. Examination revealed inflamed labia minora. The postvoiding residual was 100 ml. A straight catheter sample was obtained for culture and due to well-documented allergies to penicillin, sulfa, and nitrofurantoin, another course of ciprofloxacin was prescribed (250 mg BID for 10 days). Nystatin-triamcinolone ointment and zinc oxide were prescribed for the perivulvar dermatitis. Urine culture yielded Ͼ50,000 CFU/ml of a microaerophilic, alpha-hemolytic, gram-positive bacillus that was both catalase and oxidase negative. In view of these characteristics together with a very characteristic Gram stain morphology, the organism was presumptively identified as a Lactobacillus species and was judged to be a contaminant.The nocturia, frequency, and dysuria did not resolve, and she returned 6 weeks later. She described a postvoiding sensation of "sand in my bladder." No systemic symptoms occurred in the interval. An examination showed improved but residual erythema and mild edema of the labia minora and introitus. The vaginal epithelium was intact with mild erythema suggesting atrophy. A straight catheter urine sample was obtained, and the patient was given another course of ciprofloxacin for 10 days. Urine microscopy showed significant pyuria with white blood cell (WBC) clumps and many bacteria, and culture again yielded Ͼ50,000 CFU/ml of a Lactobacillus sp., which was again considered to be a contaminant.After no improvement following the third course of ciprofloxacin treatment, an infectious disease consult was obtained. Urine studies were repeated. Again, urine microscopy showed significant pyuria, WBC clumping, and many bacteria, and culture grew Ͼ50,000 CFU/ml of a Lactobacillus species. Etest MICs determined on Mueller-Hinton agar incuba...

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“…Infections by Lactobacillus gasseri are rarely reported in the literature. A case of Fournier gangrene [2], urinary tract infection [11], and polymicrobial empyema [7] were previously reported. In this case, we present the first monomicrobial Lactobacillus gasseri bilateral empyema that was successfully treated by video-assisted thoracoscopic surgery along with chest tube placement and drainage.…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus gasseri Causing Bilateral Empyema

Esquibel

Dababneh

Palraj

2017

Case Reports in Infectious Diseases

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Lactobacilli are common commensal bacteria found in the gastrointestinal and genitourinary tract. Although they are usually thought to be nonpathogenic, there have been several cases that demonstrate severe infections caused by these microorganisms. This is a case of a 49-year-old male with previously undiagnosed type two diabetes mellitus who presented with a 3-month history of cough and was found to have right sided Lactobacillus gasseri empyema for which he underwent video-assisted thoracoscopic surgery (VATS) with chest tube placement. He subsequently developed a left sided pleural empyema for which the aspiration also grew out L. gasseri. The patient made a complete recovery and was seen for four months in follow-up after his initial presentation.

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Lactobacillus gasseri as the cause of septic urinary infection

Cited by 36 publications

References 16 publications

Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

Molecular Analysis and Clinical Significance of Lactobacillus spp. Recovered from Clinical Specimens Presumptively Associated with Disease

Lactobacillus delbrueckii as the Cause of Urinary Tract Infection

Lactobacillus gasseri Causing Bilateral Empyema

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