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[Case report: two Leuconostoc bacteremia cases].

H Aygün1, G Yilmaz Bozkurt, O Memikoğlu

  • 1Ankara Universitesi Tip Fakültesi, Klinik Bakteriyoloji ve infeksiyon Hastaliklarl Anabilim Dali, Ankara.

Mikrobiyoloji Bulteni
|September 1, 2005
PubMed
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Leuconostoc species can cause vancomycin-resistant infections in vulnerable patients. Prompt identification and alternative antibiotics like clindamycin are crucial for successful treatment of Leuconostoc bacteremia.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Leuconostoc species, part of the Streptococcaceae family, are increasingly recognized as opportunistic pathogens.
  • Infections typically occur in immunocompromised individuals, those with central venous catheters, or prior vancomycin treatment.
  • Vancomycin resistance in Leuconostoc poses a significant clinical challenge.

Observation:

  • Two cases of Leuconostoc bacteremia are presented in patients with underlying conditions (colon adenocarcinoma and a pineal lesion).
  • Both patients had received vancomycin therapy, which proved ineffective, and presented with vancomycin-resistant Gram-positive cocci in blood and catheter cultures.
  • Initial cultures in the first case identified methicillin-resistant Staphylococcus aureus, complicating the diagnostic process.

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Findings:

  • Isolates were identified as Leuconostoc spp. using the API 20 strep system.
  • The Leuconostoc isolates exhibited resistance to vancomycin and teicoplanin but remained sensitive to penicillin, ampicillin, clindamycin, gentamicin, and chloramphenicol.
  • Successful treatment was achieved with clindamycin in both cases.

Implications:

  • Leuconostoc species should be considered in the differential diagnosis when vancomycin-resistant organisms with a Gram-positive cocci morphology, resembling streptococci, are isolated from blood cultures.
  • This highlights the need for vigilant microbiological surveillance and susceptibility testing in critically ill patients.
  • Effective alternative antibiotic strategies, such as clindamycin, are crucial for managing Leuconostoc infections.