title: Lactobacillus species as emerging pathogens in neutropenic patients.
abstract: The intensive use of broad-spectrum antibiotics in the context of prolonged and severe neutropenia has contributed to the emergence of unusual pathogens. Four new cases of severe Lactobacillus infections-three of septicemia and one of pneumonia-are reported. They occurred in patients with acute leukemia who had chemotherapy-induced neutropenia. All patients were treated in the same intensive care unit and received the same antimicrobial prophylaxis which included a total bowel decontamination containing vancomycin. The four patients were treated with a combination of intravenous ceftazidime and vancomycin prior to the development of Lactobacillus infection. Improvement in the condition of all patients was obtained with a treatment including penicillin and concurrent recovery of granulopoiesis.
authors.affiliation: Service d'Hématologie Clinique, Centre Henri Becquerel, Rouen, France.
authors.forename: C
authors.initials: C
authors.lastname: Fruchart
authors.forename: A
authors.initials: A
authors.lastname: Salah
authors.forename: C
authors.initials: C
authors.lastname: Gray
authors.forename: E
authors.initials: E
authors.lastname: Martin
authors.forename: A
authors.initials: A
authors.lastname: Stamatoullas
authors.forename: G
authors.initials: G
authors.lastname: Bonmarchand
authors.forename: J F
authors.initials: JF
authors.lastname: Lemeland
authors.forename: H
authors.initials: H
authors.lastname: Tilly
mesh_terms: D000328:Adult; D002442:Ceftazidime / Q000008:administration & dosage; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007778:Lactobacillus / Q000187:drug effects / Q000472:pathogenicity*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy / Q000382:microbiology*; D009894:Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology*; D010406:Penicillins / Q000008:administration & dosage; D014640:Vancomycin / Q000008:administration & dosage
chemical_list: D010406:Penicillins; D014640:Vancomycin; D002442:Ceftazidime