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鼠李糖乳杆菌 GG 引起的败血症,源于富含益生菌的酸奶,发生于自体干细胞移植患者。

Septicemia from Lactobacillus rhamnosus GG, from a Probiotic Enriched Yogurt, in a Patient with Autologous Stem Cell Transplantation.

机构信息

Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan.

Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.

出版信息

Probiotics Antimicrob Proteins. 2019 Mar;11(1):295-298. doi: 10.1007/s12602-018-9399-6.

Abstract

Probiotic-rich foods are consumed without much restriction. We report here, a case of septic shock caused by yogurt derived Lactobacillus species in a 54-year-old male patient with acute promyelocytic leukemia, in second complete remission, and who was an autologous stem cell transplantation recipient. He received high dose chemotherapy and autologous peripheral blood stem cell transplantation. He ingested commercially available probiotic-enriched yogurt because of severe diarrhea. One week later, he developed septic shock, and the pathogen was determined by strain-specific PCR analysis as Lactobacillus rhamnosus GG (ATCC 53103), which was found to be identical with the strain in the yogurt he consumed. Thus, because even low virulent Lactobacilli in the probiotic products can be pathogenic in the compromised hosts, ingestion of such products should be considered with caution in neutropenic patients with severe diarrhea, such as stem cell transplantation recipients.

摘要

富含益生菌的食物可以不受限制地食用。我们在此报告一例由酸奶衍生的乳杆菌属引起的败血症性休克,发生于一名 54 岁男性,患有急性早幼粒细胞白血病,处于第二次完全缓解期,且为自体干细胞移植受者。他接受了大剂量化疗和自体外周血干细胞移植。由于严重腹泻,他摄入了市售富含益生菌的酸奶。一周后,他出现败血症性休克,通过菌株特异性 PCR 分析确定病原体为鼠李糖乳杆菌 GG(ATCC 53103),与他所食用酸奶中的菌株完全相同。因此,由于益生菌产品中即使是低毒力的乳杆菌也可能在免疫功能受损的宿主中引起疾病,因此对于中性粒细胞减少且伴有严重腹泻的患者(如干细胞移植受者),应谨慎摄入此类产品。

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