title: A mixed infection of Leuconostoc lactis and vancomycin-resistant Enterococcus in a liver transplant recipient.
abstract: Bacterial infection in patients who have undergone liver transplantation is a major complication of the procedure. Leuconostoc spp. are important pathogenic bacteria in individuals with poor immune function, especially transplant patients. In this report, we describe the case of a 45-year-old Asian male liver transplant recipient who was initially preliminarily diagnosed with infection with Leuconostoc pseudomesenteroides by using the microbial tests of the VITEK 2 system and the aesculin hydrolysis test, and with vancomycin-resistant Enterococcus. Subsequently, the Leuconostoc isolate was identified as Leuconostoc lactis by 16S rRNA gene partial sequencing. In this paper, we discuss our identification of L. lactis based on physiological characteristics and molecular methodology. Accurate identification of these infections is important for the outcome; use of 16S rRNA gene sequence analysis offers a rapid and precise diagnostic approach. Administration of the drug linezolid may be useful for the treatment of both Leuconostoc spp. and vancomycin-resistant Enterococcus infections. We suggest that clinical analysts should use molecular methods in addition to biochemical tests in order to identify Leuconostoc at the species level more accurately.
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Deng
authors.affiliation: Intensive Care Units, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China.
authors.forename: Zhongwei
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
authors.forename: Yulin
authors.initials: Y
authors.lastname: Xiao
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
authors.forename: Mei
authors.initials: M
authors.lastname: Kang
authors.affiliation: Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, PR China.
authors.forename: Hong
authors.initials: H
authors.lastname: Fan
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016983:Enterococcus / Q000187:drug effects* / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology*; D006801:Humans; D007934:Leuconostoc / Q000302:isolation & purification*; D000069349:Linezolid; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D023303:Oxazolidinones / Q000627:therapeutic use; D018805:Sepsis / Q000382:microbiology; D020713:Vancomycin Resistance / Q000235:genetics*
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D000069349:Linezolid