Lactobacillus bacteremia and endocarditis: Review of 45 cases
Lactobacillus bacteremia and endocarditis: Review of 45 cases
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DOI：
10.1086/516109
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发表时间：
1997-11-01
影响因子：
11.8
通讯作者：
Longworth, DL
中科院分区：
文献类型：
--
作者：
Husni, RN;Gordon, SM;Longworth, DL
乳酸杆菌是正常胃肠道和泌尿生殖道植物群的一部分，但却是菌血症的一种罕见原因。我们回顾了超过15年的45例具有临床意义的嗜酸菌血症患者的病例。基础疾病很常见，包括癌症（40%），近期手术（38%）和糖尿病（27%）。22名患者在发生败血症时在重症监护室。45例患者中有11例接受免疫抑制治疗，11例接受全肠外营养，23例在发生菌血症前接受了对乳杆菌无活性的抗生素。27例患者的菌血症为多种微生物，39例在住院期间发生。31例患者死亡，但只有1例死亡可归因于细菌血症。乳酸杆菌是相对无毒的病原体，在患有严重基础疾病的患者中产生菌血症，其中许多人先前接受过抗生素治疗，可能会选择该微生物。虽然本身很少致命，但细菌血症可识别严重和快速致命疾病的患者。
Lactobacilli are part of normal gastrointestinal and genitourinary flora but are an uncommon cause of bacteremia. We reviewed the cases of 45 patients with clinically significant lactobacillus bacteremia occurring over 15 years. Underlying conditions were common, including cancer (40%), recent surgery (38%), and diabetes mellitus (27%). Twenty-two patients were in the intensive care unit at the time of onset of lactobacillus bacteremia. Eleven of the 45 patients were receiving immunosuppressive therapy, 11 were receiving total parenteral nutrition, and 23 had received antibiotics without activity against Lactobacillus prior to the occurrence of bacteremia. Bacteremia was polymicrobial in 27 patients and developed during hospitalization in 39. Thirty-one patients died, but only one death was attributable to lactobacillus bacteremia. Lactobacilli are relatively avirulent pathogens that produce bacteremia in patients with serious underlying illnesses, many of whom have received prior antibiotic therapy that may select out for the organism. While rarely fatal in itself, lactobacillus bacteremia identifies patients with serious and rapidly fatal illness.