Abstract
Two new cases of significant bacteremia caused byLeuconostoc spp. are reported and five others described in the literature are reviewed. Four of the seven patients were under one year old and presented with prolonged diarrhea related to gastrointestinal disorders. The remaining three patients were over 50 years of age and being treated in intensive care units. Six patients had nosocomially acquired catheter-related bacteremia.Leuconostoc spp. are naturally resistant to vancomycin, and five patients had received this antibiotic for prior bacteremia caused by methicillin-resistant staphylococci. The majority of patients presented with fever without severe complications. Penicillin is the treatment of choice and there is no report of any death directly attributable to infection by these microorganisms. Infection withLeuconostoc spp. should be suspected if “vancomycin-resistant streptococci” are isolated from the blood, and recorded as a potential cause of bacteremia in patients with indwelling intravenous catheters.
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References
Ruoff KL: Gram-positive vancomycin-resistant clinical isolates. Clinical Microbiology Newsletter 1989, 11: 1–4.
Garvie EI: Separation of species of the genusLeuconostoc and differentiation of the leuconostoes from other lactic acid bacteria. Methods in Microbiology 1984, 16: 147–178.
Rogosa M, Sharpe ME: Species differentiation of human vaginal lactobacilli. Journal of General Microbiology 1960, 23: 197–201.
Garvie EI: GenusLeuconostoc. In: Sneath PHA, Mair NS, Sharpe ME, Holt JG (ed): Bergey's manual of systematic bacteriology. Volume 1. Williams & Williams, Baltimore, 1986, p. 1071–1075.
Buu-Hoi A, Branger C, Acar JF: Vancomycin-resistant streptococci orLeuconostoc sp. Antimicrobial Agents and Chemotherapy 1985, 28: 458–460.
Coovadia YM, Solwa Z, Van Den Ende J: Potential pathogenicity ofLeuconostoc. Lancet 1988, i: 306.
Coovadia YM, Solwa Z, Van Den Ende J: Meningitis caused by vancomycin-resistantLeuconostoc sp. Journal of Clinical Microbiology 1987, 25: 1784–1785.
Dyas A, Chauhan N: Vancomycin resistantLeuconostoc. Lancet 1988, i: 306.
Horowitz HW, Handwerger S, Van Horn KG, Wormser GP:Leuconostoc, an emerging vancomycin-resistant pathogen. Lancet 1987, ii: 1329–1330.
Hardy S, Ruoff KL, Catlin EA, Santos JI: Catheter-associated infection with a vancomycin-resistant grampositive coccus of theLeuconostoc sp. Pediatric Infectious Diseases Journal 1988, 7: 519–520.
Rubin LG, Velozzi E, Shapiro J, Isenberg HD: Infection with vancomycin-resistant “streptococci” due toLeuconostoc species. Journal of Infectious Diseases 1988, 157: 216.
Golledge CL: Bacteremia due toLeuconostoc species. Clinical Microbiology Newsletter 1989, 11: 4–5.
Colman G: Vancomycin-resistant leuconostocs, lactobacilli and now pediococci. Journal of Hospital Infection 1987, 10: 1–3.
Colman G, Ball LC: Identification of streptococci in a medical laboratory. Journal of Applied Bacteriology 1984, 57: 1–14.
Facklam R, Hollis D, Collins MD: Identification of gram-positive coccal and coccobacillary vancomycin-resistant bacteria. Journal of Clinical Microbiology 1989, 27: 724–730.
Fertally SS, Facklam R: Comparison of physiologic tests used to identify non-beta-hemolytic aerococci, enterococci, and streptococci. Journal of Clinical Microbiology 1987, 25: 1845–1850.
Facklam RR, Collins MD: Identification ofEnterococcus species isolated from human infections by a conventional test scheme. Journal of Clinical Microbiology 1989, 27: 731–734.
Isenberg HD, Vellozzi EM, Shapiro J, Rubin LG: Clinical laboratory challenges in the recognition ofLeuconostoc spp. Journal of Clinical Microbiology 1988, 26: 479–483.
National Committee for Clinical Laboratory Standards Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved standard M7-A. NCCLS, Villanova, PA, 1985.
Maki DG, Weise CE, Sarafin HW: A semiquantitative method for identifying intravenous-catheter-related infection. New England Journal of Medicine 1977, 140: 1305–1309.
Liñares J, Sitges-Serra A, Garau J, Perez JL, Martin R: Pathogenesis of catheter related sepsis: a prospective study with quantitative and semiquantitative cultures of catheter hub and segments. Journal of Clinical Microbiology 1985, 21: 357–360.
Cercenado E, Ena J, Rodríguez-Créixems M, Romero I, Bouza E: A conservative procedure for the diagnosis of catheter-related infection. Archives of Internal Medicine 1990, 150: 1417–1420.
Shlaes DM, Marino J, Jacobs MR: Infection caused by vancomycin-resistantStreptococcus sanguis II. Antimicrobial Agents and Chemotherapy 1984, 25: 527–528.
Thornsberry C, Facklam RR: Vancomycin resistant streptococci? Probably not. Antimicrobial Newsletter 1984, 8: 63–64.
Ruoff KL, Kuritzkes DR, Wolfson JS, Ferraro MJ: Vancomycin resistant gram-positive bacteria isolated from human sources. Journal of Clinical Microbiology 1988, 26: 2064–2068.
Orberg PK: Common occurrence of plasmid DNA and vancomycin resistance ofLeuconostoc sp. Applied and Environmental Microbiology 1984, 48: 1129–1133.
Barna JCJ, Williams GH: The structure and mode of action of glycopeptide antibiotics of the vancomycin group. Annual Review of Microbiology 1984, 38: 339–343.
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Bernaldo de Quirós, J.C.L., Muñoz, P., Cercenado, E. et al. Leuconostoc species as a cause of bacteremia: Two case reports and a literature review. Eur. J. Clin. Microbiol. Infect. Dis. 10, 505–509 (1991). https://doi.org/10.1007/BF01963938
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DOI: https://doi.org/10.1007/BF01963938