Division of Infectious Diseases, Juravinski Cancer Centre, McMaster University Infectious Diseases Residency Program, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada.
Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.
BMC Infect Dis. 2021 May 1;21(1):403. doi: 10.1186/s12879-021-06095-7.
Carnobacterium species are lactic acid-producing Gram-positive bacteria that have been approved by the US Food and Drug Administration and Health Canada for use as a food bio-preservative. The use of live bacteria as a food additive and its potential risk of infections in immunocompromised patients are not well understood.
An 81-year-old male with a history of metastatic prostate cancer on androgen deprivation therapy and chronic steroids presented to our hospital with a 2-week history of productive cough, dyspnea, altered mentation, and fever. Extensive computed tomography imaging revealed multifocal pneumonia without other foci of infection. He was diagnosed with pneumonia and empirically treated with ceftriaxone and vancomycin. Blood cultures from admission later returned positive for Carnobacterium inhibens. He achieved clinical recovery with step-down to oral amoxicillin/clavulanic acid for a total 7-day course of antibiotics.
This is the fourth reported case of bacteremia with Carnobacterium spp. isolated from humans. This case highlights the need to better understand the pathogenicity and disease spectrum of bacteria used in the food industry for bio-preservation, especially in immunocompromised patients.
乳球菌属是产乳酸的革兰氏阳性细菌，已被美国食品和药物管理局以及加拿大卫生部批准作为食品生物防腐剂使用。将活细菌用作食品添加剂及其对免疫功能低下患者感染的潜在风险尚未得到很好的理解。
一名 81 岁男性，患有转移性前列腺癌，正在接受雄激素剥夺治疗和长期类固醇治疗，因有 2 周的咳痰、呼吸困难、意识改变和发热病史而到我院就诊。广泛的计算机断层扫描成像显示多灶性肺炎，无其他感染灶。他被诊断为肺炎，并经验性地接受头孢曲松和万古霉素治疗。入院时的血培养后来阳性培养出抑菌乳球菌。他通过降阶梯治疗，口服阿莫西林/克拉维酸，总共使用 7 天的抗生素后临床康复。
这是第四例从人类分离出抑菌乳球菌属的菌血症报告。该病例强调需要更好地了解用于食品工业生物保鲜的细菌的致病性和疾病谱，特别是在免疫功能低下的患者中。
