Lactobacillus bacteremia: Pathogen or prognostic marker?

Area of Science:

• Infectious Diseases
• Microbiology
• Clinical Medicine

Background:

• Lactobacillus bacteremia (LB) is an uncommon bloodstream infection with poorly understood epidemiology.
• The clinical significance of LB, whether it represents contamination, a risk factor, or a marker of mortality, remains unclear.

Purpose of the Study:

• To investigate the epidemiology and clinical significance of Lactobacillus bacteremia.
• To determine if LB is associated with patient outcomes and underlying comorbidities.

Main Methods:

• A retrospective study was conducted at Grenoble University Hospital from January 2005 to December 2014.
• Identified patients with Lactobacillus bacteremia and analyzed associated clinical factors and outcomes.

Main Results:

• Lactobacillus bacteremia occurred in 38 patients (0.34% of positive blood cultures), frequently associated with cancer, immunosuppression, and central venous devices.
• A significant temporal increase in LB was observed (P=0.04).
• Secondary bacteremia with a known portal of entry showed a significantly higher case fatality rate (55.2% at 1 year) compared to isolated bacteremia (12.5% at 1 year), and was associated with increased mortality (OR 14.9, P=0.047).

Conclusions:

• Lactobacillus bacteremia may serve as a marker for disease severity and underlying comorbidities, rather than being a primary pathogen.
• LB should not be dismissed as contamination; it necessitates screening for associated infections and underlying conditions.