TY - JOUR
T1 - Antibiotics may predispose to lactobacillemia in liver transplant patients
AU - Patel, R.
AU - Cockerill, F. R.
AU - Porayko, M. K.
AU - Keating, M. R.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 1993
Y1 - 1993
N2 - Lactobacilli are ubiquitous inhabitants of the human oral cavity, vagina, and gastrointestinal tract, that are generally considered non-pathogenic. We retrospectively reviewed all positive blood cultures for Lactobacillus species (sp.) from liver transplant recipients at our institution. Eight cases of lactobacillus bacteremia were identified. Selective bowel decontamination with non-absorbable oral antibiotics was administered to all patients. Additionally, all patients received intravenous vancomycin; most isolates exhibited either in vitro or in vivo vancomycin resistance. The biliary anastomosis in each patient was a Roux-Y choledochojejunostomy. The underlying clinical conditions included perihepatic abscesses in two patients, biliary strictures with either hepatic abscesses or infected bile in four, and heaptic infarctions with necrosis and infection of the liver in two. The use of selective bowel deontamination, intravenous vancomycin and Roux-Y choledochojejunostomy in liver transplantation patients may predispose to lactobacillemia.
AB - Lactobacilli are ubiquitous inhabitants of the human oral cavity, vagina, and gastrointestinal tract, that are generally considered non-pathogenic. We retrospectively reviewed all positive blood cultures for Lactobacillus species (sp.) from liver transplant recipients at our institution. Eight cases of lactobacillus bacteremia were identified. Selective bowel decontamination with non-absorbable oral antibiotics was administered to all patients. Additionally, all patients received intravenous vancomycin; most isolates exhibited either in vitro or in vivo vancomycin resistance. The biliary anastomosis in each patient was a Roux-Y choledochojejunostomy. The underlying clinical conditions included perihepatic abscesses in two patients, biliary strictures with either hepatic abscesses or infected bile in four, and heaptic infarctions with necrosis and infection of the liver in two. The use of selective bowel deontamination, intravenous vancomycin and Roux-Y choledochojejunostomy in liver transplantation patients may predispose to lactobacillemia.
KW - Bacteremia
KW - Choledochojejunostomy
KW - Lactobacillus
KW - Liver transplantation
KW - Selective bowel decontamination
KW - Vancomycin
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U2 - 10.1016/0924-8579(93)90015-W
DO - 10.1016/0924-8579(93)90015-W
M3 - Article
C2 - 18611563
AN - SCOPUS:0027730723
SN - 0924-8579
VL - 3
SP - 215
EP - 219
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
IS - 3
ER -