TY - JOUR
T1 - Breakthrough Lactobacillus rhamnosus GG bacteremia associated with probiotic use in an adult patient with severe active ulcerative colitis
T2 - case report and review of the literature
AU - Meini, Simone
AU - Laureano, Raffaele
AU - Fani, Lucia
AU - Tascini, Carlo
AU - Galano, Angelo
AU - Antonelli, Alberto
AU - Rossolini, Gian Maria
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Probiotics are widely investigated in the treatment of various bowel diseases. However, they may also have a pathogenic potential, and the role of Lactobacillus spp. as opportunistic pathogens, mostly following disruption of the intestinal mucosa, is emerging. Case report: We report on a case of bacteremia caused by L. rhamnosus GG in an adult patient affected by severe active ulcerative colitis under treatment with corticosteroids and mesalazine. Lactobacillus bacteremia was associated with candidemia and occurred while the patient was receiving a probiotic formulation containing the same strain (as determined by PFGE typing), and was being concomitantly treated with i.v. vancomycin, to which the Lactobacillus strain was resistant. L. rhamnosus GG bacteremia, therefore, was apparently related with translocation of bacteria from the intestinal lumen to the blood. Conclusions: Pending conclusive evidence, use of probiotics should be considered with caution in case of active severe inflammatory bowel diseases with mucosal disruption.
AB - Background: Probiotics are widely investigated in the treatment of various bowel diseases. However, they may also have a pathogenic potential, and the role of Lactobacillus spp. as opportunistic pathogens, mostly following disruption of the intestinal mucosa, is emerging. Case report: We report on a case of bacteremia caused by L. rhamnosus GG in an adult patient affected by severe active ulcerative colitis under treatment with corticosteroids and mesalazine. Lactobacillus bacteremia was associated with candidemia and occurred while the patient was receiving a probiotic formulation containing the same strain (as determined by PFGE typing), and was being concomitantly treated with i.v. vancomycin, to which the Lactobacillus strain was resistant. L. rhamnosus GG bacteremia, therefore, was apparently related with translocation of bacteria from the intestinal lumen to the blood. Conclusions: Pending conclusive evidence, use of probiotics should be considered with caution in case of active severe inflammatory bowel diseases with mucosal disruption.
KW - Bacteremia
KW - Lactobacillus rhamnosus
KW - Probiotic
KW - Ulcerative colitis
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U2 - 10.1007/s15010-015-0798-2
DO - 10.1007/s15010-015-0798-2
M3 - Article
C2 - 26024568
AN - SCOPUS:84948097330
VL - 43
SP - 777
EP - 781
JO - Infection
JF - Infection
SN - 0300-8126
IS - 6
ER -