Breakthrough Lactobacillus rhamnosus GG bacteremia associated with probiotic use in an adult patient with severe active ulcerative colitis: case report and review of the literature
Abstract
Background Probiotics are widely investigated in the treatment of various bowel diseases. However, they may also have a pathogenic potential, and the role of Lactobacillus spp. as opportunistic pathogens, mostly following disruption of the intestinal mucosa, is emerging. Case report We report on a case of bacteremia caused by L. rhamnosus GG in an adult patient affected by severe active ulcerative colitis under treatment with corticosteroids and mesalazine. Lactobacillus bacteremia was associated with candidemia and occurred while the patient was receiving a probiotic formulation containing the same strain (as determined by PFGE typing), and was being concomitantly treated with i.v. vancomycin, to which the Lactobacillus strain was resistant. L. rhamnosus GG bacteremia, therefore, was apparently related with translocation of bacteria from the intestinal lumen to the blood. Conclusions Pending conclusive evidence, use of probiotics should be considered with caution in case of active severe inflammatory bowel diseases with mucosal disruption.
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Our review of the literature (from 1980 to 2023) found 23 cases where the blood isolate from a bacteremic patient was identical to the probiotic strain the patient had been taking.
“Our review of the literature (from 1980 to 2023) found 23 cases where the blood isolate from a bacteremic patient was identical to the probiotic strain the patient had been taking.”
From Lactobacillus Bacteremia and Probiotics: A Review (2023) · cites this paper as [60]
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- Authors
- Meini, S., Laureano, R., Fani, L., Tascini, C., Galano, A., Antonelli, A., & Rossolini, G. M.
- Affiliations
- Ospedale Santa Maria Annunziata (IT)
- Ospedale Cisanello (IT)
- University of Siena (IT)
- Corresponding author
- Meini, Simone
- Venue
- Infection
- Published
- 2015-05-30
- Volume
- 43
- Issue
- 6
- Pages
- 777-781
- ISSN
- 0300-8126 (ISSN-L)
- 1439-0973
- OpenAlex
- W2132814753
- Cited by
- 106
- References
- 21
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 11 · 2023: 16 · 2022: 15 · 2021: 12 · 2020: 9 · 2019: 7 · 2018: 7 · 2017: 9 · 2016: 7 · 2015: 1
- FWCI
- 10.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Infection (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (University of Udine) (submittedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Use Siena air (University of Siena) (submittedVersion)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- Lactobacillus rhamnosus GG, bacteremia, probiotics, ulcerative colitis, opportunistic pathogens, candidemia, vancomycin resistance, bacterial translocation, inflammatory bowel disease, 5-aminosalicylic acid, corticosteroids
- MeSH terms
- Adrenal Cortex Hormones, Anti-Inflammatory Agents, Anti-Bacterial Agents, Colitis, Ulcerative, Female, Genotype, Humans, Middle Aged, Vancomycin, Bacteremia, Electrophoresis, Gel, Pulsed-Field, Mesalamine, Probiotics, Drug Resistance, Bacterial, Lacticaseibacillus rhamnosus, Candidemia, Molecular Typing
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