Husni R N, Gordon S M, Washington J A, Longworth D L
Department of Infectious Diseases, The Cleveland Clinic Foundation, Ohio 44195, USA.
Clin Infect Dis. 1997 Nov;25(5):1048-55. doi: 10.1086/516109.
Lactobacilli are part of normal gastrointestinal and genitourinary flora but are an uncommon cause of bacteremia. We reviewed the cases of 45 patients with clinically significant lactobacillus bacteremia occurring over 15 years. Underlying conditions were common, including cancer (40%), recent surgery (38%), and diabetes mellitus (27%). Twenty-two patients were in the intensive care unit at the time of onset of lactobacillus bacteremia. Eleven of the 45 patients were receiving immunosuppressive therapy, 11 were receiving total parenteral nutrition, and 23 had received antibiotics without activity against Lactobacillus prior to the occurrence of bacteremia. Bacteremia was polymicrobial in 27 patients and developed during hospitalization in 39. Thirty-one patients died, but only one death was attributable to lactobacillus bacteremia. Lactobacilli are relatively avirulent pathogens that produce bacteremia in patients with serious underlying illnesses, many of whom have received prior antibiotic therapy that may select out for the organism. While rarely fatal in itself, lactobacillus bacteremia identifies patients with serious and rapidly fatal illness.
乳酸杆菌是正常胃肠道和泌尿生殖系统菌群的一部分，但却是菌血症的罕见病因。我们回顾了15年间发生的45例具有临床意义的乳酸杆菌菌血症病例。基础疾病很常见，包括癌症（40%）、近期手术（38%）和糖尿病（27%）。22例患者在乳酸杆菌菌血症发作时处于重症监护病房。45例患者中有11例正在接受免疫抑制治疗，11例正在接受全胃肠外营养，23例在菌血症发生前接受过对乳酸杆菌无活性的抗生素治疗。27例患者的菌血症为多微生物感染，39例在住院期间发生。31例患者死亡，但只有1例死亡归因于乳酸杆菌菌血症。乳酸杆菌是相对无毒力的病原体，在患有严重基础疾病的患者中引起菌血症，其中许多患者此前接受过抗生素治疗，这可能会筛选出该病原体。虽然乳酸杆菌菌血症本身很少致命，但它可识别出患有严重且迅速致命疾病的患者。
