Lactobacillus rhamnosus endocarditis: An unusual culprit in a patient with Barlow's disease

Felekos, Ioannis; Lazaros, George; Tsiriga, Athanasia; Pirounaki, Maria; Stavropoulos, George; Paraskevas, Joseph; Toutouza, Marina; Tousoulis, Dimitrios

doi:10.1016/j.hjc.2016.11.011

Cited by 8 publications

(5 citation statements)

References 12 publications

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“…Revision of their full texts allowed selection of 31 reports that raised safety concerns, all of which described human pathological processes. The claimed aetiological agents comprise L. acidophilus (Cohen et al., ; Haghighat and Crum‐Cianflone, ; Hubbard et al., ), L. animalis (Somayaji et al., ), L. casei (Passera et al., ; Vanichanan et al., ; Pailhories et al., ; Stroupe et al., ; de Seynes et al., ), L. coryniformis (Datta et al., ), L. delbrueckii (Chaini et al., ; Maillet et al., ), L. gasseri (Chaini et al., ; Elikowski et al., ; Esquibel et al., ), L. paracasei (Harding‐Theobald and Maraj, ; Kao et al., ; Kato et al., ; Pararajasingam and Uwagwu, ), L. plantarum (Biesiada et al., ), L. rhamnosus (Felekos et al., ; Molinaro et al., ; Aaron et al., ; Norena et al., ; Boumis et al., ; Kane et al., ; Koyama et al., ; Naqvi et al., ; Nayeem et al., ; Zeba et al., ) and L. salivarius (Garcia Carretero et al., ; Wang et al., ).…”

Section: Assessmentmentioning

confidence: 99%

Scientific Opinion on the update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA (2017–2019)

Koutsoumanis¹,

Allende²,

Álvarez‐Ordóñez³

et al. 2020

EFS2

249

207

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The qualified presumption of safety (QPS) was developed to provide a safety pre‐assessment within EFSA for microorganisms. Strains belonging to QPS taxonomic units (TUs) still require an assessment based on a specific data package, but QPS status facilitates fast track evaluation. QPS TUs are unambiguously defined biological agents assessed for the body of knowledge, their safety and their end use. Safety concerns are, where possible, to be confirmed at strain or product level, and reflected as ‘qualifications’. Qualifications need to be evaluated at strain level by the respective EFSA units. The lowest QPS TU is the species level for bacteria, yeasts and protists/algae, and the family for viruses. The QPS concept is also applicable to genetically modified microorganisms used for production purposes if the recipient strain qualifies for the QPS status, and if the genetic modification does not indicate a concern. Based on the actual body of knowledge and/or an ambiguous taxonomic position, the following TUs were excluded from the QPS assessment: filamentous fungi, oomycetes, streptomycetes, Enterococcus faecium, Escherichia coli and bacteriophages. The list of QPS‐recommended biological agents was reviewed and updated in the current opinion and therefore now becomes the valid list. For this update, reports on the safety of previously assessed microorganisms, including bacteria, yeasts and viruses (the latter only when used for plant protection purposes) were reviewed, following an Extensive Literature Search strategy. All TUs previously recommended for 2016 QPS list had their status reconfirmed as well as their qualifications. The TUs related to the new notifications received since the 2016 QPS opinion was periodically evaluated for QPS status in the Statements of the BIOHAZ Panel, and the QPS list was also periodically updated. In total, 14 new TUs received a QPS status between 2017 and 2019: three yeasts, eight bacteria and three algae/protists.

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Section: Assessmentmentioning

confidence: 99%

Scientific Opinion on the update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA (2017–2019)

Koutsoumanis¹,

Allende²,

Álvarez‐Ordóñez³

et al. 2020

EFS2

249

207

View full text Add to dashboard Cite

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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%

“…Moreover, cases of resistance to tetracyclines, ciprofloxacin, or carbapenems have also been reported [78]. A possible mechanism of resistance to these agents is lactic acid production, leading to lower pH levels and decreased effectiveness of antimicrobials [71]. Duration of therapy should be per standard guidelines for IE treatment.…”

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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“…IE is a severe disease with significant morbidity and mortality that often occurs on the basis of primary heart disease and may be combined with valve perforations. Clinically, sporadic cases of BD complicated with IE have been reported . Heart failure, uncontrolled and persistent infection, and recurrent embolic events are the major indications for valve surgery in patients with IE …”

Section: Discussionmentioning

confidence: 99%

“…Clinically, sporadic cases of BD complicated with IE have been reported. [5][6][7] Heart failure, uncontrolled and persistent infection, and recurrent embolic events are the major indications for valve surgery in patients with IE. 8 CLI is a new term suggested on the basis of 3D-TEE findings.…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional echocardiography of mitral Barlow's disease with infective endocarditis: Perforations or cleft‐like indentations?

Pang

Wang

Liu

et al. 2019

J of Clinical Ultrasound

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Barlow's disease is a complicated form of degenerative mitral valve (MV) disease. Infective endocarditis (IE) often occurs on the basis of primary heart diseases and may be combined with valve perforations. Cleft‐like indentations (CLIs) were suggested by Ring et al. in 2013. They are located at the inter‐scallop position and involve at least one‐half of the valve. Herein, we report a case of Barlow's disease combined with IE and CLIs, which was confirmed intra‐operatively and by histopathological examination. The CLIs were misdiagnosed by two‐dimensional transthoracic echocardiography as perforations, but rightly interpreted by preoperative three‐dimensional echocardiography. The possibility of CLIs should be considered in the evaluation of mitral regurgitation caused by myxomatous MV diseases.

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Lactobacillus rhamnosus endocarditis: An unusual culprit in a patient with Barlow's disease

Cited by 8 publications

References 12 publications

Scientific Opinion on the update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA (2017–2019)

Scientific Opinion on the update of the list of QPS‐recommended biological agents intentionally added to food or feed as notified to EFSA (2017–2019)

Infective Endocarditis by Lactobacillus Species—A Narrative Review

Three‐dimensional echocardiography of mitral Barlow's disease with infective endocarditis: Perforations or cleft‐like indentations?

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