Lactobacillus bacteremia, species identification, and antimicrobial susceptibility of 85 blood isolates
Abstract
BACKGROUND: Data regarding antimicrobial susceptibility of clinical Lactobacillus isolates are scarce, and appropriate interpretation criteria for susceptibility tests are not available. METHODS: We examined 85 cases of Lactobacillus bacteremia, of which 47 cases have been included in our previous studies. Overall, 14 antimicrobial agents were evaluated by the E-test method, and these results were compared with disk diffusion test findings. The clinical outcomes of the patients and their antimicrobial treatments were registered. RESULTS: The antimicrobial susceptibility of Lactobacillus strains was species dependent. The considerable number of Lactobacillus rhamnosus (n=46), Lactobacillus fermentum (n=12), and Lactobacillus casei (n=12) strains available for testing made it possible to compare the susceptibilities within 1 species, as well. Of the 46 L. rhamnosus isolates, 22 were identified as L. rhamnosus GG type by pulsed-field gel electrophoresis. All Lactobacillus isolates demonstrated low minimum inhibitory concentrations (MICs) of imipenem, piperacillin-tazobactam, erythromycin, and clindamycin. MICs of vancomycin were high (>256 microg/mL) for all other species except Lactobacillus gasseri and Lactobacillus jensenii. Disk diffusion and E-test results were concordant. The MICs of cephalosporins varied; cefuroxime demonstrated a higher level of activity than did ceftriaxone. Benzylpenicillin and ampicillin MICs had variable ranges between different species. Combination therapy was given to 83% of the patients, but, in 54% of them, therapy included only 1 microbiologically active agent, according to results of the susceptibility tests. Mortality at 1 week was 12% among patients who presumably were receiving adequate treatment and 27% among patients who were receiving inadequate treatment (P=.131, by E-test). CONCLUSION: Most clinical Lactobacillus blood isolates demonstrated low MICs of imipenem, piperacillin-tazobactam, erythromycin, and clindamycin, but they had variable susceptibility to penicillin and cephalosporins.
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The most common species isolated from LB blood samples is Lcb. rhamnosus GG (ATCC53103).
“The most common species isolated from LB blood samples is Lcb. rhamnosus GG (ATCC53103) [6,7,15,22,23,24].”
From Lactobacillus Bacteremia and Probiotics: A Review (2023) · cites this paper as [23]
The Results report that L. rhamnosus was the most numerous species (46 isolates), including 22 classified as L. rhamnosus GG type. The Identification section defines “GG type” by an indistinguishable PFGE pattern; the Isolates and patients section identifies ATCC 53103 as a separate reference strain used in testing. The paper therefore does not establish that the most common blood isolate was the exact ATCC 53103 strain. (LLM, conf=0.87)
Experimental — accuracy not yet measuredOther Lactobacillus species less frequently reported in LB include Lcb. paracasei, L. acidophilus, L. jensenii, Lpb. plantarum, and Lsb. fermentum.
“Other Lactobacillus species have been less frequently reported: Lcb. paracasei [7], Lactobacillus (L.) acidophilus [7,15], L. jensenii [7,23,26], Lactiplantibacillus (Lpb.) plantarum [7,27], and Limosilactobacillus (Lsb.) fermentum [7,23].”
From Lactobacillus Bacteremia and Probiotics: A Review (2023) · cites this paper as [23]
The Results and isolate-count tables (pages not supplied) document blood isolates of L. fermentum, L. jensenii, and L. plantarum, with fewer isolates than L. rhamnosus. Our copy does not document L. paracasei or L. acidophilus among the blood isolates; paracasei appears only in a reference about peritonitis, not bacteremia. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSecond-generation cephalosporin and cefuroxime showed greater activity against lactobacilli compared with third-generation cephalosporin and ceftriaxone.
“In general, second-generation cephalosporin and cefuroxime showed greater activity against lactobacilli, compared with third-generation cephalosporin and ceftriaxone, which is in accordance with earlier observations.”
From Lactobacillus Bacteremia and Probiotics: A Review (2023) · cites this paper as [23]
All isolates demonstrated low minimum inhibitory concentrations (MICs) against imipenem, piperacillin-tazobactam, erythromycin, and clindamycin.
“All isolates demonstrated low minimum inhibitory concentrations (MICs) against imipenem, piperacillin–tazobactam, erythromycin, and clindamycin.”
From Lactobacillus Bacteremia and Probiotics: A Review (2023) · cites this paper as [23]
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- Authors
- Salminen, M. K., Rautelin, H., Tynkkynen, S., Poussa, T., Saxelin, M., Valtonen, V., & Jarvinen, A.
- Affiliations
- Helsinki University Hospital (FI)
- University of Helsinki (FI)
- Valio (Finland) (FI)
- Corresponding author
- Salminen, M. K.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-03-01
- Volume
- 42
- Issue
- 5
- Pages
- e35-e44
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2159982881
- Cited by
- 218
- References
- 31
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 12 · 2023: 19 · 2022: 17 · 2021: 8 · 2020: 12 · 2019: 11 · 2018: 8 · 2017: 15 · 2016: 2 · 2015: 12 · 2014: 7 · 2013: 7 · 2012: 3
- FWCI
- 25.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Valio
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- antimicrobial susceptibility, Lactobacillus rhamnosus, Lactobacillus fermentum, Lactobacillus casei, Lactobacillus gasseri, Lactobacillus jensenii, minimum inhibitory concentration, imipenem, piperacillin-tazobactam, erythromycin, clindamycin, cephalosporins, penicillin, vancomycin, combination antibiotic therapy, mortality, species identification
- MeSH terms
- Anti-Bacterial Agents, Humans, Lactobacillus, Microbial Sensitivity Tests, Species Specificity, Bacteremia, Drug Resistance, Bacterial
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