title: Leuconostoc bacteremia after liver transplantation: another cause of vancomycin resistant gram-positive infection.
abstract: Leuconostoc sp. are gram-positive bacteria intrinsically resistant to vancomycin, which can be confused with streptococci based on routine microbiological-characteristics. Infections secondary to Leuconostoc are uncommon, and usually affect patients with underlying diseases, prior use of vancomycin and those with central lines. The most common clinical presentation is fever secondary to a central line infection. We report the first case of Leuconostoc infection in a solid organ transplant recipient. The patient developed Leuconostoc bacteremia secondary to peritonitis, 60 d after undergoing liver transplantation. He was treated with clindamycin, gentamicin and underwent surgical debridement, but succumbed to other complications.
authors.affiliation: Department of Medicine, University of Pittsburgh, Pannsylvania, USA.
authors.forename: R
authors.initials: R
authors.lastname: Espinoza
authors.forename: S
authors.initials: S
authors.lastname: Kusne
authors.forename: A W
authors.initials: AW
authors.lastname: Pasculle
authors.forename: S
authors.initials: S
authors.lastname: Wada
authors.forename: J
authors.initials: J
authors.lastname: Fung
authors.forename: J
authors.initials: J
authors.lastname: Rakela
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation; D002981:Clindamycin / Q000627:therapeutic use; D003646:Debridement; D004352:Drug Resistance, Microbial; D017809:Fatal Outcome; D005334:Fever / Q000209:etiology; D005500:Follow-Up Studies; D005839:Gentamicins / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D007934:Leuconostoc / Q000187:drug effects; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D010538:Peritonitis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D013290:Streptococcal Infections / Q000382:microbiology; D014640:Vancomycin / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002981:Clindamycin; D014640:Vancomycin