title: Pathogenic relevance of Lactobacillus: a retrospective review of over 200 cases.
abstract: Given that Lactobacillus has been reported to be the causative pathogen in many types of infection despite debate regarding the organism's clinical significance, a literature review was conducted to investigate the treatments and outcomes of Lactobacillus infections reported to date. In this article, the characteristics of over 200 reported cases of Lactobacillus-associated infections are summarized. Lactobacillus was found to be frequently associated with endocarditis and bacteremia. Lactobacillus was also associated with a variety of other infections including, but not limited to, peritonitis, abscesses, and meningitis. The species casei and rhamnosus were the most common. The isolates tended to be most sensitive to erythromycin and clindamycin and most resistant to vancomycin. The species that was most sensitive to vancomycin was acidophilus. The overall mortality rate was nearly 30%. There was a significant association between mortality and polymicrobial infection (P=0.004). In the subset of patients with bacteremia, increased mortality was associated with inadequate treatment (P=0.001) and polymicrobial bacteremia (P=0.044).
authors.affiliation: Edward Hines, Jr. VA Hospital, Pharmacy Service, 119 5th Avenue and Roosevelt Road, Hines, IL 60141, USA.
authors.forename: J P
authors.initials: JP
authors.lastname: Cannon
authors.forename: T A
authors.initials: TA
authors.lastname: Lee
authors.forename: J T
authors.initials: JT
authors.lastname: Bolanos
authors.forename: L H
authors.initials: LH
authors.lastname: Danziger
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007778:Lactobacillus / Q000145:classification* / Q000187:drug effects; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents