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Probiotics and Antimicrobial Proteins

, Volume 11, Issue 1, pp 295–298 | Cite as

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

  • Satoshi Koyama
  • Hiroyuki FujitaEmail author
  • Takeshi Shimosato
  • Aki Kamijo
  • Yasufumi Ishiyama
  • Eri Yamamoto
  • Yoshimi Ishii
  • Yukako Hattori
  • Maki Hagihara
  • Etsuko Yamazaki
  • Naoto Tomita
  • Hideaki Nakajima
  • On behalf of the Yokohama Cooperative Study Group for Hematology (YACHT)
Article

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.

Keywords

Lactobacillus Probiotic yogurt, bacteremia Leukemia Stem cell transplantation 

Notes

Compliance with Ethical Standards

Conflicts of Interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest. The authors declare that the final manuscript has not been published before and the work is not under consideration for publication elsewhere.

Informed Consent

Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent may be requested for review from the corresponding author.

References

  1. 1.
    Salminen S, von Wright A, Morelli L, Marteau P, Brassart D, de Vos WM, Fondén R, Saxelin M, Collins K, Mogensen G, Birkeland SE, Mattila-Sandholm T (1998) Demonstration of safety of probiotics -- a review. Int J Food Microbiol 44:93–106CrossRefGoogle Scholar
  2. 2.
    Wells JM (2011) Immunomodulatory mechanisms of lactobacilli. Microb Cell Factories 10(Suppl 1):S17CrossRefGoogle Scholar
  3. 3.
    Srinivasan R, Meyer R, Padmanabhan R, Britto J (2006) Clinical safety of lactobacillus casei shirota as a probiotic in critically ill children. J Pediatr Gastroenterol Nutr 42:171–173CrossRefGoogle Scholar
  4. 4.
    Antony SJ, Stratton CW, Dummer JS (1996) Lactobacillus bacteremia: description of the clinical course in adult patients without endocarditis. Clin Infect Dis 23:773–778CrossRefGoogle Scholar
  5. 5.
    Griffiths JK, Daly JS, Dodge RA (1992) Two cases of endocarditis due to lactobacillus species: antimicrobial susceptibility, review, and discussion of therapy. Clin Infect Dis 15:250–255CrossRefGoogle Scholar
  6. 6.
    Sussman JI, Baron EJ, Goldberg SM, Kaplan MH, Pizzarello RA (1986) Clinical manifestations and therapy of lactobacillus endocarditis: report of a case and review of the literature. Rev Infect Dis 8:771–776CrossRefGoogle Scholar
  7. 7.
    Land MH, Rouster-Stevens K, Woods CR, Cannon ML, Cnota J, Shetty AK (2005) Lactobacillus sepsis associated with probiotic therapy. Pediatrics 115:178–181CrossRefGoogle Scholar
  8. 8.
    Vahabnezhad E, Mochon AB, Wozniak LJ, Ziring DA (2013) Lactobacillus bacteremia associated with probiotic use in a pediatric patient with ulcerative colitis. J Clin Gastroenterol 47:437–439CrossRefGoogle Scholar
  9. 9.
    Mehta A, Rangarajan S, Borate U (2013) A cautionary tale for probiotic use in hematopoietic SCT patients-lactobacillus acidophilus sepsis in a patient with mantle cell lymphoma undergoing hematopoietic SCT. Bone Marrow Transplant 48:461–462CrossRefGoogle Scholar
  10. 10.
    Ward LJ, Timmins MJ (1999) Differentiation of lactobacillus casei, lactobacillus paracasei and lactobacillus rhamnosus by polymerase chain reaction. Lett Appl Microbiol 29:90–92CrossRefGoogle Scholar
  11. 11.
    Ahlroos T, Tynkkynen S (2009) Quantitative strain-specific detection of lactobacillus rhamnosus GG in human faecal samples by real-time PCR. J Appl Microbiol 106:506–514CrossRefGoogle Scholar
  12. 12.
    Salminen MK, Rautelin H, Tynkkynen S, Poussa T, Saxelin M, Valtonen V, Järvinen A (2004) Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG. Clin Infect Dis 38:62–69CrossRefGoogle Scholar
  13. 13.
    Fenicia L, Anniballi F, Aureli P (2007) Intestinal toxemia botulism in Italy, 1984-2005. Eur J Clin Microbiol Infect Dis 26:385–394CrossRefGoogle Scholar
  14. 14.
    Howard FM, Flynn DM, Bradley JM, Noone P, Szawatkowski M (1977) Outbreak of necrotising enterocolitis caused by clostridium butyricum. Lancet 2:1099–1102CrossRefGoogle Scholar
  15. 15.
    Kimura SI, Fujita H, Kato H, Hiramoto N, Hosono N, Takahashi T, Shigeno K, Hatsumi N, Minamiguchi H, Miyatake J, Handa H, Akiyama N, Kanda Y, Yoshida M, Kiyoi H, Miyazaki Y, Naoe T; Japan Adult Leukemia Study Group (JALSG). (2017) Management of infection during chemotherapy for acute leukemia in Japan: a nationwide questionnaire-based survey by the Japan Adult Leukemia Study Group. Support Care Cancer. Jun 6.  https://doi.org/10.1007/s00520-017-3775-8
  16. 16.
    Gardner A, Mattiuzzi G, Faderl S, Borthakur G, Garcia-Manero G, Pierce S, Brandt M, Estey E (2008) Randomized comparison of cooked and noncooked diets in patients undergoing remission induction therapy for acute myeloid leukemia. J Clin Oncol 26:5684–5688CrossRefGoogle Scholar
  17. 17.
    Moody K, Finlay J, Mancuso C, Charlson M (2006) Feasibility and safety of a pilot randomized trial of infection rate: neutropenic diet versus standard food safety guidelines. J Pediatr Hematol Oncol 28:126–133CrossRefGoogle Scholar
  18. 18.
    van Tiel F, Harbers MM, Terporten PH, van Boxtel RT, Kessels AG, Voss GB, Schouten HC (2007) Normal hospital and low-bacterial diet in patients with cytopenia after intensive chemotherapy for hematological malignancy: a study of safety. Ann Oncol 18:1080–1084CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Satoshi Koyama
    • 1
    • 2
  • Hiroyuki Fujita
    • 1
    • 3
    Email author
  • Takeshi Shimosato
    • 4
  • Aki Kamijo
    • 5
  • Yasufumi Ishiyama
    • 1
    • 2
  • Eri Yamamoto
    • 1
    • 6
  • Yoshimi Ishii
    • 1
    • 6
  • Yukako Hattori
    • 1
    • 7
  • Maki Hagihara
    • 1
  • Etsuko Yamazaki
    • 1
    • 8
  • Naoto Tomita
    • 1
    • 9
  • Hideaki Nakajima
    • 1
  • On behalf of the Yokohama Cooperative Study Group for Hematology (YACHT)
  1. 1.Department of Hematology and Clinical ImmunologyYokohama City University School of MedicineYokohamaJapan
  2. 2.Department of Hematology, Kanagawa Cancer CenterYokohamaJapan
  3. 3.Department of Hematology, Saiseikai Yokohama Nanbu HospitalYokohamaJapan
  4. 4.Research Center for Fungal and Microbial DynamismShinshu UniversityKamiinaJapan
  5. 5.Department of TransfusionYokohama City University HospitalYokohamaJapan
  6. 6.Department of Hematology, Yokohama City University Medical CenterYokohamaJapan
  7. 7.Department of Hematology, Fujisawa City HospitalFujisawaJapan
  8. 8.Clinical Laboratory DepartmentYokohama City University HospitalYokohamaJapan
  9. 9.Division of Hematology and Oncology, Department of Internal MedicineSt. Marianna University School of MedicineKawasakiJapan

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