Bacteraemia Caused by Probiotic Strains of Lacticaseibacillus rhamnosus—Case Studies Highlighting the Need for Careful Thought before Using Microbes for Health Benefits
Open accessAbstract
Lactic acid bacteria belonging to Lactobacillus spp. and Lacticaseibacillus spp. are a natural part of fermented milk and other food products, probiotic supplements and human microbiota. They mainly belong to mucosal microflora, especially oral, vaginal and intestinal. Lacticaseibacillus spp. strains included in probiotics are generally characterised as safe microorganisms, and the species are concerned bacteria with very low pathogenic potential. However, infections caused by Lactobacillus spp. and Lacticaseibacillus spp., including bacteraemia and endocarditis, occur occasionally. The aim of the study was to present two cases of bacteraemia due to Lacticaseibacillus rhamnosus associated with the use of a probiotic product. It afflicted patients in intensive care units. The investigation was preliminarily based on clinical and microbiological recognition of the cases. The initial observation was laboratory confirmed with the application of pulsed-field gel electrophoresis (PFGE) results. Identical PFGE patterns were obtained for the evaluated strains and the strains derived from a commercially available probiotic that was administered to those patients. The increasing number of studies describing opportunistic infections due to probiotic strains of Lacticaseibacillus spp. should result in verifying the safety of probiotic formulations used in immunocompromised patients and forming detailed guidelines for the use of probiotics among patients from several risk groups.
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One report described 93 cases of serious infections with a 15% mortality rate, including fungemia (37.6%), sepsis (31.2%), bacteremia (20.4%), endocarditis, and abscesses.
“For example, one report on observational results described 93 cases of serious infections (with a 15% mortality rate), with fungemia (37.6% of cases), sepsis (31.2%), bacteremia (20.4%), endocarditis, and abscesses [74,75].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [75]
The Introduction and Discussion and Conclusions (page unavailable) describe bacteraemia, sepsis, endocarditis and abscesses as possible infections or complications. They do not report an observational series of 93 cases, a 15% mortality rate, fungemia, or the claimed percentages. The Discussion instead gives an estimated 30% mortality among patients with LAB infections, a different population from the claimed series. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe theoretical assumption that excessive immune stimulation through probiotics could lead to an autoimmune response resulting in inflammation has not been confirmed.
“The theoretical assumption that excessive stimulation of the immune system through probiotics could lead to an autoimmune response resulting in inflammation has not been confirmed [75].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [75]
The Discussion and Conclusions addresses probiotic-associated infections and safety testing, but does not address whether excessive immune stimulation can cause an inflammatory autoimmune response or whether that hypothesis has been confirmed. Searches for autoimmune response, immune stimulation, and the hypothesis being unconfirmed found no passage addressing it; our copy has no page numbers for the cited passages. (LLM, conf=0.75)
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References 47 · Cited by 38
Research works printed but not linked: 1
- (2022, February 04). Probiotics in Food: Health and Nutritional Properties and Guidelines for Evaluation—NLM Catalog—NCBI, Available online: https://www.ncbi.nlm.nih.gov/nlmcatalog/101617803.
- Authors
- Mikucka, A., Deptuła, A., Bogiel, T., Chmielarczyk, A., Nurczyńska, E., & Gospodarek-Komkowska, E.
- Affiliations
- Nicolaus Copernicus University (PL)
- Jagiellonian University (PL)
- Anesthesiology and Intensive Care Unit, University Hospital No 1 in Bydgoszcz, 85-094 Bydgoszcz, Poland
- Corresponding author
- Bogiel, Tomasz
- ORCID
- Venue
- Pathogens
- Publisher
- MDPI AG
- Published
- 2022-08-26
- Volume
- 11
- Issue
- 9
- Pages
- 977
- ISSN
- 2076-0817 (ISSN-L)
- PMC
- PMC9504050
- OpenAlex
- W4293769485
- Cited by
- 38
- References
- 47
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 11 · 2023: 6 · 2022: 1
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Pathogens (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Homo Politicus (Academy of Humanities and Economics in Lodz) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Nicolaus Copernicus University (PDB WF 839)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Infections and bacterial resistance
- Keywords
- Lactobacillus rhamnosus, bacteremia, probiotic safety, immunocompromised patients, intensive care unit patients, probiotic supplements, pulsed-field gel electrophoresis typing, opportunistic infections
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