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[乳杆菌血症:免疫功能低下患者中的罕见病症。1例临床病例描述及文献综述]

[Lactobacillemia: A Rare Entity in Immunocompromised Patients. Description of a Clinical Case and Literature Review].

作者信息

Cornacchiari Marina, Mudoni Anna, Liccardo Amelia, Visciano Bianca, Rizzo Maria Antonietta, Cuoccio Paola, Di Toma Luca Francesco

机构信息

ASST Ovest Milanese sede Magenta.

U.O. Nefrologia e Dialisi, Pia Fondazione di Culto e religione, Azienda Ospedaliera Cardinale G. Panico, Tricase (Le).

出版信息

G Ital Nefrol. 2024 Aug 26;41(4):2024-vol4. doi: 10.69097/41-04-2024-08.

Abstract

Bacteremia caused by Lactobacillus is rare, data on its clinical significance are based only on case reports and a limited number of studies, often difficult to interpret. Lactobacillus species is a commensal colonizer of the mouth, gastrointestinal and genitourinary tract. Its significance as a pathogen is overlooked frequently. The diagnosis of these infections requires a mutual relationship between the physician and the microbiologist to rule out contamination risk. Most patients with Lactobacillus bacteremia are immunosuppressed or patients at increased risk of symptomatic bacteremia with comorbidities, treated with broad-spectrum antibiotics and have indwelling venous catheters. Risk factors related to Lactobacillus bacteremia include impaired host defenses and severe underlying diseases, as well as prior surgery and prolonged antibiotic therapy ineffective for lactobacilli. We describe an unusual case of a woman, on chronic hemodialysis treatment, with a sepsis due to Lactobacillus casei and review the literature.

摘要

乳酸杆菌引起的菌血症较为罕见,关于其临床意义的数据仅基于病例报告和有限的研究,且常常难以解读。乳酸杆菌属是口腔、胃肠道和泌尿生殖道的共生定植菌。其作为病原体的重要性常被忽视。这些感染的诊断需要医生和微生物学家相互协作,以排除污染风险。大多数乳酸杆菌菌血症患者存在免疫抑制,或因合并症而有发生症状性菌血症的风险增加,接受过广谱抗生素治疗且留置有静脉导管。与乳酸杆菌菌血症相关的危险因素包括宿主防御功能受损、严重基础疾病,以及既往手术和对乳酸杆菌无效的长期抗生素治疗。我们描述了一例正在接受慢性血液透析治疗的女性因干酪乳杆菌导致败血症的罕见病例,并对相关文献进行综述。

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