Lactobacillus rhamnosus infection in a child following bone marrow transplant

Kalima, Pota; Masterton, R.G.; Roddie, P. H.; Thomas, Angela

doi:10.1016/s0163-4453(96)91622-9

Cited by 60 publications

(31 citation statements)

References 11 publications

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“…Cases of serious infection have occurred and been reported in the literature. 10,[118][119][120][121][122][123][124][125] Patients at risk would be those who are immunocompromised, including ill preterm neonates, and/or children who have intravenous catheters or other indwelling medical devices. In most cases, the offending organism that caused the sepsis seems to have stemmed from bacteria from the individual's own endogenous flora.…”

Section: Safety Of Probiotics and Prebiotics In Infants And Childrenmentioning

confidence: 99%

Probiotics and Prebiotics in Pediatrics

Thomas¹,

Greer²

2010

Pediatrics

357

220

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This clinical report reviews the currently known health benefits of probiotic and prebiotic products, including those added to commercially available infant formula and other food products for use in children. Probiotics are supplements or foods that contain viable microorganisms that cause alterations of the microflora of the host. Use of probiotics has been shown to be modestly effective in randomized clinical trials (RCTs) in (1) treating acute viral gastroenteritis in healthy children; and (2) preventing antibiotic-associated diarrhea in healthy children. There is some evidence that probiotics prevent necrotizing enterocolitis in very low birth weight infants (birth weight between 1000 and 1500 g), but more studies are needed. The results of RCTs in which probiotics were used to treat childhood Helicobacter pylori gastritis, irritable bowel syndrome, chronic ulcerative colitis, and infantile colic, as well as in preventing childhood atopy, although encouraging, are preliminary and require further confirmation. Probiotics have not been proven to be beneficial in treating or preventing human cancers or in treating children with Crohn disease. There are also safety concerns with the use of probiotics in infants and children who are immunocompromised, chronically debilitated, or seriously ill with indwelling medical devices. Prebiotics are supplements or foods that contain a nondigestible food ingredient that selectively stimulates the favorable growth and/or activity of indigenous probiotic bacteria. Human milk contains substantial quantities of prebiotics. There is a paucity of RCTs examining prebiotics in children, although there may be some long-term benefit of prebiotics for the prevention of atopic eczema and common infections in healthy infants. Confirmatory well-designed clinical research studies are necessary.

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Section: Safety Of Probiotics and Prebiotics In Infants And Childrenmentioning

confidence: 99%

Probiotics and Prebiotics in Pediatrics

Thomas¹,

Greer²

2010

Pediatrics

357

220

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“…However, some cases of local or systemic infections, including septicemia, meningitis, and endocarditis, due to LAB have been reported, but they account for only a very small number of bacteremia cases (the incidence of causation is 5 to 15% for enterococci and 0.1% for lactobacilli) (12,21,22). Moreover, most LAB strains linked to clinical cases belong to the species Enterococcus faecium and E. faecalis, but a few belong to L. rhamnosus, L. casei or L. paracasei, and L. plantarum (1,8).…”

mentioning

confidence: 99%

Assessment of Safety ofLactobacillusStrains Based on Resistance to Host Innate Defense Mechanisms

Asahara

Takahashi

Nomoto

et al. 2003

Clin Vaccine Immunol

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Seven Lactobacillus strains belonging to four species were evaluated for pathogenicity as well as for in vitro sensitivity to the bactericidal mechanisms of macrophages in a rabbit infective endocarditis (IE) model. Two bacteremia-associated strains, L. rhamnosus PHLS A103/70 and L. casei PHLS A357/84, as well as the L. rhamnosus type strain and the probiotic L. rhamnosus strain ATCC 53103, showed moderate infectivity, and the virulence of the probiotic L. casei strain Shirota and type strains such as L. acidophilus ATCC 4356 T and L. gasseri DSM 20243 T in the model was negligible. The strains that showed pathogenic potential in the rabbit IE model (PHLS A357/84, PHLS A103/70, and ATCC 53103) were more resistant than strain Shirota to intracellular killing activity by mouse macrophages in vitro and also to bactericidal nitrogen intermediates, such as nitric oxide and NO 2 ؊ ions. These results suggest that resistance to host innate defense systems, which would function at inflammatory lesions, should be considered in the safety assessment of Lactobacillus strains.The widespread use of lactic acid bacteria (LAB) in fermented foods and dairy products has a long history, and most strains are considered commensal microorganisms with no pathogenic potential. Members of the genus Lactobacillus in particular have been shown to inhabit the human gastrointestinal tract, and the long history of safe use of many species of lactobacillus gave them generally-recognized-as-safe status (13, 23).However, some cases of local or systemic infections, including septicemia, meningitis, and endocarditis, due to LAB have been reported, but they account for only a very small number of bacteremia cases (the incidence of causation is 5 to 15% for enterococci and 0.1% for lactobacilli) (12,21,22). Moreover, most LAB strains linked to clinical cases belong to the species Enterococcus faecium and E. faecalis, but a few belong to L. rhamnosus, L. casei or L. paracasei, and L. plantarum (1,8). Infective endocarditis (IE) is the most common infection to be associated with lactobacilli, and recent reports show that relatively restricted species of Lactobacillus, such as L. casei and L. rhamnosus, are the most commonly associated with IE, although the frequency of occurrence of Lactobacillus endocarditis is very low, as evidenced by previous studies (for reviews, see reference 8). A European Union-sponsored workshop organized by the Lactic Acid Bacteria Industrial Platform examined these infections and judged that in all cases reported thus far, only patients with abnormal heart valves or immunocompromised states appeared to be infected with the patients' own indigenous lactic acid bacteria. The workshop concluded that the risk of infection due to all LAB, excluding enterococci, is very low when they are ingested (1, 17). Nevertheless, the workshop also proposed that the safety of each strain should be checked by appropriate methods.In the present report, we describe the results of the assessment of the safety of seven Lactobacillus strains bel...

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“…Appropriate diagnostic and therapeutic measures should be immediately initiated in such cases. endocarditis post -tonsillectomy with history of congenital heart disease Kalima et al 4 5 yr bacteremia and pericardial effusion following bone marrow transplant Brook …”

Section: Discussionmentioning

confidence: 99%