Datta Priya, Gupta Varsha, Mohi Gursimran Kaur, Chander Jagdish, Janmeja Ashok Kumar
Assistant Professor, Department of Microbiology, Government Medical College and Hospital , Chandigarh, India .
Professor, Department of Microbiology, Government Medical College and Hospital , Chandigarh, India .
J Clin Diagn Res. 2017 Feb;11(2):DE01-DE05. doi: 10.7860/JCDR/2017/22837.9391. Epub 2017 Feb 1.
Lactobacilli are normal commensals of the gastrointestinal and female genital tract. Due to its low virulence these bacteria are known to cause opportunistic infections. They cause mostly bacteraemia with or without endocarditis and rarely cause pleuro-pulmonary infection. We report a case of pleuro-pulmonary infection and review 14 previously reported cases of lactobacilli causing pleuro-pulmonary infections. Our patient had small cell carcinoma with metastasis. All the 14 cases had pre-existing risk factors like immunosuppresion, cancer or chronic disease. There was no consensus on choice of antimicrobial agents to be used. Different species of lactobacilli were involved. Available susceptibility data showed that lactobacilli species were more susceptible to ampicillin, erythromycin, gentamycin, and clindamycin and decreased to ceftriaxone, ciprofloxacin and trimethoprim-sulphamethoxazole. Isolation of species from a case of pleuro-pneumonia infection could be a marker of poor long-term prognosis. The diagnosis of these infections requires both microbiologist and clinical correlation to rule out contamination.
乳酸杆菌是胃肠道和女性生殖道的正常共生菌。由于其低毒力，这些细菌已知会引起机会性感染。它们主要引起伴有或不伴有心内膜炎的菌血症，很少引起胸膜肺部感染。我们报告一例胸膜肺部感染病例，并回顾14例先前报道的乳酸杆菌引起胸膜肺部感染的病例。我们的患者患有小细胞癌并伴有转移。所有14例病例都有免疫抑制、癌症或慢性病等既往危险因素。对于使用何种抗菌药物尚无共识。涉及不同种类的乳酸杆菌。现有的药敏数据表明，乳酸杆菌属对氨苄西林、红霉素、庆大霉素和克林霉素更敏感，而对头孢曲松、环丙沙星和甲氧苄啶-磺胺甲恶唑的敏感性降低。从一例胸膜肺炎感染病例中分离出菌种可能是长期预后不良的一个标志。这些感染的诊断需要微生物学家和临床的相互关联以排除污染。
