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An 11-Year Review of Lactobacillus Bacteremia at a Pediatric Tertiary Care Center
Yosefa Hefter1, Lauren Powell1, Christine E Tabulov2
1Divisions of Infectious Diseases.
Insights
Lactobacillus bacteremia is rare in pediatric inpatients, with only 8 cases over 11 years. Probiotic use did not correlate with increased bacteremia, but certain patient factors indicate higher risk.
Area of Science:
- Microbiology
- Pediatric Infectious Diseases
- Clinical Pharmacy
Background:
- Probiotics are widely used in pediatric care.
- The risk of Lactobacillus bacteremia in hospitalized children is not well-defined.
- Informing clinical decisions requires understanding bacteremia incidence and risk factors.
Purpose of the Study:
- To determine the incidence of Lactobacillus bacteremia in pediatric inpatients.
- To identify patient characteristics and risk factors associated with Lactobacillus bacteremia.
- To assess the correlation between probiotic administration and bacteremia rates.
Main Methods:
- Retrospective review of 8 cases of Lactobacillus bacteremia over 11 years in a tertiary-care pediatric hospital.
- Analysis of patient charts for symptoms, risk factors (probiotic use, central venous catheter, immunocompromise, intestinal dysfunction, age <3 months).
- Assessment of concurrent inpatient probiotic administration data.
Main Results:
- Eight cases of Lactobacillus bacteremia identified among 127,845 admissions.
- All cases presented with systemic signs of infection.
- Frequent risk factors included impaired intestinal function and central venous catheters; 3 cases had prior probiotic use.
- Bacteremia incidence did not correlate with peak probiotic administration periods.
Conclusions:
- Lactobacillus bacteremia is uncommon in pediatric inpatients and not directly correlated with hospital probiotic administration volumes.
- Certain patient populations, particularly those with impaired intestinal function or central venous catheters, may be at increased risk.
- Clinical decisions regarding probiotic use in vulnerable pediatric populations require careful consideration of individual risk factors.
Objectives:
To inform clinical decisions on the use of probiotics in a pediatric inpatient setting, we sought to determine the number of cases of Lactobacillus bacteremia as well as associated patient characteristics in a tertiary-care pediatric hospital over an 11-year period.
Methods:
Cases of Lactobacillus bacteremia among admitted patients were identified through positive blood culture reports. The clinical chart for each case was reviewed for presenting symptoms and risk factors such as probiotic use, presence of a central venous catheter, immunocompromised state, impaired intestinal function, and age below 3 months. Concurrent total inpatient probiotic administration was assessed.
Results:
Over an 11-year period, 8 cases of Lactobacillus bacteremia were identified among 127 845 hospital admissions. All cases were associated with systemic signs of infection. Lactobacillus bacteremia patients most frequently had underlying impaired intestinal function and a central venous catheter. Three cases had a history of probiotic use. The peak number of annual cases did not coincide with the peak number of inpatients who received probiotics.
Conclusions:
Lactobacillus bacteremia is uncommon and did not correlate with doses of probiotics-administered in the hospital. However, certain populations may be at higher risk and require extra consideration in clinical decision-making regarding use of probiotics.
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