Diagnostic difficulties of Lactobacillus casei bacteraemia in immunocompetent patients: a case report.
Diagnostic difficulties of Lactobacillus casei bacteraemia in immunocompetent patients: a case report.
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DOI：
10.1186/1752-1947-2-315
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发表时间：
2008-09-30
影响因子：
1
通讯作者：
Nicastri E
中科院分区：
文献类型：
--
作者：
Tommasi C;Equitani F;Masala M;Ballardini M;Favaro M;Meledandri M;Fontana C;Narciso P;Nicastri E
乳酸杆菌目前被提议作为几种膳食产品中的益生菌剂。在血培养中，它们通常被认为是污染物，但近年来，它们已被认为是心内膜炎、尿路感染、脑膜炎、腹腔内感染和菌血症的致病感染因子。我们报告一例干酪乳杆菌菌血症在一个66岁的免疫功能正常的男子与历史的发热原因不明。血培养证实为明串珠菌血症，但随后的聚合酶链反应分析和16S核糖体RNA测序鉴定为干酪乳杆菌，并进行了成功的抗生素治疗。由益生菌引起的菌血症很少见，但被低估了，因为它们通常被视为污染物，并且它们作为主要入侵者的作用并不总是容易确定。虽然益生菌产品的消费不能被认为是由通常非致病性细菌引起的疾病发展的风险因素，但应考虑特定的个体临床病史。这份报告应提醒临床医生和微生物学家，不寻常的病原体引起严重疾病的可能性，并使用16S核糖体RNA测序的分子鉴定作为一个强大的工具，在确认罕见的病原体的诊断。
Lactobacilli are currently proposed as probiotic agents in several dietary products. In blood cultures, they are usually considered as contaminants, but in recent years they have been recognized as causal infectious agents of endocarditis, urinary tract infections, meningitis, intra-abdominal infections and bacteraemia. We report a case of Lactobacillus casei bacteraemia in a 66-year-old immunocompetent man with a history of fever of unknown origin. Leuconostoc bacteraemia was demonstrated by blood culture, but a later polymerase chain reaction analysis with sequencing of 16S ribosomal RNA identified Lactobacillus casei and a successful antibiotic therapy was performed. Bacteraemia caused by probiotic organisms is rare but underestimated, since they are normally regarded as contaminants and their role as primary invaders is not always easily established. Although the consumption of probiotic products cannot be considered a risk factor in the development of diseases caused by usually non-pathogenic bacteria, specific individual clinical histories should be taken into account. This report should alert both clinicians and microbiologists to the possibility of unusual pathogens causing serious illnesses and to the use of 16S ribosomal RNA sequencing for molecular identification as a powerful tool in confirming the diagnosis of infrequent pathogens.