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Lactococcus lactis Catherter-Related Bloodstream Infection in an Infant: Case Report
Ayşe Karaaslan1, Ahmet Soysal, Abdurrahman Sarmış
1Department of Pediatrics and Division of Pediatric Infectious Diseases, Medical School, Marmara University.
Insights
Lactococcus lactis, typically nonpathogenic, caused a bloodstream infection in an infant with Down syndrome and Hirschsprung's disease. This case highlights the need to consider L. lactis as a potential pathogen in vulnerable pediatric patients.
Area of Science:
- Medical Microbiology
- Pediatric Infectious Diseases
Background:
- Lactococcus lactis is generally considered a nonpathogenic, gram-positive bacterium.
- Infants with congenital conditions like Down syndrome and Hirschsprung's disease are at increased risk for infections.
Observation:
- A 1-year-old boy with Down syndrome and Hirschsprung's disease developed a catheter-related bloodstream infection.
- The infection was caused by Lactococcus lactis spp. lactis, identified via Vitek 2 and Vitek MS systems.
Findings:
- The patient experienced sepsis symptoms following gastrointestinal surgery and recurrent feeding intolerance.
- Blood cultures from the central venous catheter confirmed L. lactis infection.
- Successful treatment was achieved with vancomycin, despite the inability to remove the central venous catheter.
Implications:
- This case underscores that Lactococcus species, despite their usual nonpathogenic nature, can cause serious infections in immunocompromised or vulnerable infants.
- Clinicians should maintain a high index of suspicion for L. lactis in pediatric patients with risk factors and sepsis symptoms.
- Further research may be warranted to understand the pathogenic potential of L. lactis in specific clinical contexts.
Abstract:
Lactococcus lactis is a gram-positive coccus that is nonpathogenic in humans. Herein, we present the case of a 1-year-old boy with Down syndrome and Hirschprung's disease (HD) who developed a catheter-related bloodstream infection with L. lactis after gastrointestinal surgery. The patient had been hospitalized in the pediatric surgery unit from birth because of HD, and had undergone the Duhamel-Martin procedure which caused recurrent diarrhea episodes and feeding intolerance. On the infant's 430th day of life, he had an episode of gastroenteritis and feeding intolerance. Because of clinical suspiction of sepsis, blood cultures were taken both from the central venous catheter and peripheral vein, and evidence of a growing microorganism was detected in 2 different central venous catheter blood cultures taken 2 days apart. The colonies were then identified by both the Vitek 2 and Vitek MS systems (bioMérieux, Marseille, France) as L. lactis spp. lactis. The central venous catheter could not be removed because of the absence of a peripheral venous line, and the patient was subsequently successfully treated with vancomycin. Therefore, although Lactococcus species is generally thought to be nonpathogenic, it should still be kept in mind as a potential pathogen in infants.
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