Pathogenic relevance of Lactobacillus: a retrospective review of over 200 cases

Abstract

Given that Lactobacillus has been reported to be the causative pathogen in many types of infection despite debate regarding the organism's clinical significance, a literature review was conducted to investigate the treatments and outcomes of Lactobacillus infections reported to date. In this article, the characteristics of over 200 reported cases of Lactobacillus-associated infections are summarized. Lactobacillus was found to be frequently associated with endocarditis and bacteremia. Lactobacillus was also associated with a variety of other infections including, but not limited to, peritonitis, abscesses, and meningitis. The species casei and rhamnosus were the most common. The isolates tended to be most sensitive to erythromycin and clindamycin and most resistant to vancomycin. The species that was most sensitive to vancomycin was acidophilus. The overall mortality rate was nearly 30%. There was a significant association between mortality and polymicrobial infection (P=0.004). In the subset of patients with bacteremia, increased mortality was associated with inadequate treatment (P=0.001) and polymicrobial bacteremia (P=0.044).

Clinical Impact of Probiotics among Patients Receiving Antibiotics with a High Risk of Acquiring Clostridium difficile Infection

“…Lactobacillus rhamnosus (GG) was found to have the second highest rate of isolation (22.9%) in a study of 241 cases of infection caused by probiotics. Mortality rates from these Lactobacillus-associated infections was found to be 29.1% (P=0.004) in a case series study [29]. These infections have been associated with patients who have received recent surgery, organ transplant, or have diabetes mellitus, AIDS, or cancer [30].…”

“…Probiotics should not be considered as risk-free agents, since cases of probiotic-associated endocarditis as well as bacteremia have been reported in the literature [29]. These types of infections indicate the ability for probiotics to translocate.…”

Lekoterapia zakażeń Lactobacillus sp. – przegląd piśmiennictwa

“…W badaniach Cannona średni wiek pacjentów z lactobacillemią wynosił 53,5 roku, a z zapaleniem wsierdzia -43 lata. Stosunek mężczyzn do kobiet w lactobacillemii wyniósł około 24:17, natomiast w grupie z zapaleniem wsierdzia -5:3 [13]. Objawy sepsy z lactobacillemią obejmują głównie: gorączkę, leukocytozę i dreszcze; średni czas leczenia antybiotykami wynosi 12 dni (w badaniu Cannon terapia antybiotykowa trwała 25 dni) [5,13].…”

“…Stosunek mężczyzn do kobiet w lactobacillemii wyniósł około 24:17, natomiast w grupie z zapaleniem wsierdzia -5:3 [13]. Objawy sepsy z lactobacillemią obejmują głównie: gorączkę, leukocytozę i dreszcze; średni czas leczenia antybiotykami wynosi 12 dni (w badaniu Cannon terapia antybiotykowa trwała 25 dni) [5,13]. Kryterium potwierdzającym lactobacillemię są dwie pozytywne kultury krwi dla Lactobacillus sp.…”

“…najczęściej związany jest z zapaleniem wsierdzia [1,2,4,5]. Przyczyną bakteryjnego zapalenia wsierdzia, spowodowanego bakteriami kwasu mlekowego, w 47% są zabiegi dentystyczne [13]. W pracy Cannona śmiertelność pacjentów z różnymi zakażeniami o etiologii Lactobacillus była bardzo wysoka i wynosiła nawet 29%, a ryzyko zgonu nie było związane z typem infekcji [13].…”