title: Carbapenem-resistant Lactobacillus intra-abdominal infection in a renal transplant recipient with a history of probiotic consumption.
abstract: BACKGROUND
  Lactobacillus sp. is a low virulence bacterium, which rarely causes infection in immunocompetent individuals and usually is considered a contaminant. Normally this organism is susceptible to β-lactam antibiotics, yet resistant strains have been reported.
  
  
  METHODS
  Here, we report a case of a 60-year-old renal transplant recipient who developed an intra-abdominal abscess which grew a carbapenem-resistant Lactobacillus casei. This is significant since it is the first report of a clinical isolate of Lactobacillus sp. that demonstrated both microbiological and clinical resistance to carbapenem use. Moreover, the probiotic supplement that the patient had taken also grew a similar organism raising the concern of probiotic associated infection in immunocompromised individual.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, 6431 Fannin, MSB 2.112, Houston, TX, 77030, USA. Jakapat.Vanichanan@uth.tmc.edu.
authors.forename: Jakapat
authors.initials: J
authors.lastname: Vanichanan
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Violeta
authors.initials: V
authors.lastname: Chávez
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Audrey
authors.initials: A
authors.lastname: Wanger
authors.affiliation: Division of Renal Disease and Hypertension, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Aleksandra M
authors.initials: AM
authors.lastname: De Golovine
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, 6431 Fannin, MSB 2.112, Houston, TX, 77030, USA.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Vigil
mesh_terms: D015780:Carbapenems / Q000494:pharmacology / Q000627:therapeutic use; D016908:Gram-Positive Bacterial Infections; D006801:Humans; D059413:Intraabdominal Infections / Q000188:drug therapy / Q000382:microbiology; D007778:Lactobacillus / Q000187:drug effects / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D019936:Probiotics; D066027:Transplant Recipients; D018440:beta-Lactam Resistance
chemical_list: D015780:Carbapenems
keywords: Carbapenem; Drug resistant; Intra-abdominal infection; Lactobacillus; Probiotic; Renal transplant