Lactobacillus Rhamnosus

Indications as a Probiotic (see Probiotics)

Prevention of Respiratory Infection

Clinical Efficacy

Systematic Review of Lactobacillus Rhamnosus GG for the Prevention of Respiratory Infections in Children (Indian Pediatr, 2013) [MEDLINE]
- Lactobacillus Rhamnosus GG Decreased the Incidence of Acute Otitis Media, Upper Respiratory Infections, and Antibiotic Use in Children

Treatment of Acute Gastroenteritis (see Acute Gastroenteritis)

Clinical Efficacy

Review of Lactobacillus Rhamnosus GG for the Treatment of Acute Gastroenteritis (Pediatrics, 2013) [MEDLINE]
- Lactobacillus Rhamnosus GG Has Been Successfully Used for the Treatment of Acute Gastroenteritis: success is related to pharmacy collaboration, electronic medical record with a standardized order set, and rapid identification and mitigation of failures

Microbiology

Lactobacillus Rhamnosus is a Human Commensal Organism

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Physiology

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Diagnosis

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Clinical Manifestations

Infectious Manifestations

Bacteremia
- Epidemiology
  - Case Report of Lactobacillus Rhamnosus Bacteremia in a Lung Transplant Patient (Scand J Infect Dis, 2001) [MEDLINE]
  - Risk Factors (Clin Infect Dis, 2004) [MEDLINE]
    - Immunosuppression
    - Prior Prolonged Hospitalization
    - Prior Surgical Interventions
  - Cases Have Been Reported in Renal Transplant Patients (Transpl Infect Dis, 2015) [MEDLINE]
  - Retrospective Study of Cases of Lactobacillus Isolates from 2004-2009 (Eur J Clin Microbiol Infect Dis, 2012) [MEDLINE]
    - Lactobacillus Rhamnosus was the Most Common Lactobacillus Isolate
    - Lactobacillus Rhamnosus Bacteremia was Most Commonly Associated with Nosocomial Infection in the Setting of Immunosuppression (66% of Cases) and Catheters (83% of Cases)
  - Case Report of Lactobacillus Rhamnosus GG Bacteremia in a Patient with Inflammatory Bowel Disease Who was Taking Probiotics (Infection, 2015) [MEDLINE]

Neurologic Manifestations

Meningitis (see Meningitis)
- Epidemiology
  - Case Report in a Child with Recurrent Lactobacillus Rhamnosus Bacteremia In the Setting of Hematopoietic Stem Cell Transplant (J Clin Microbiol, 2010) [MEDLINE]

Otalaryngologic Manifestations

Oral Infection
- Epidemiology
  - Case Report in the Setting of Severe Immunosuppression Associated with Chemotherapy for Acute Myeloid Leukemia (Int J Hematol, 2014) [MEDLINE]

Pulmonary Manifestations

Aspiration Pneumonia (see Aspiration Pneumonia)
- Epidemiology
  - Case Report in an 11 Month Old Infant Who Aspirated Probiotics (J Clin Microbiol, 2014) [MEDLINE]

Treatment

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Prognosis

Mortality Rate of Lactobacillus Bacteremia
- Mortality Rate at 1 Month: 25% (Clin Infect Dis, 2004) [MEDLINE]
- Mortality Rate at 1 Year: 48% (Clin Infect Dis, 2004) [MEDLINE]

References

Catheter-related bacteremia due to Lactobacillus rhamnosus in a single-lung transplant recipient. Scand J Infect Dis. 2001;33(10):780-2 [MEDLINE]
Lactobacillus bacteremia, clinical significance, and patient outcome, with special focus on probiotic L. rhamnosus GG. Clin Infect Dis. 2004 Jan 1;38(1):62-9 [MEDLINE]
Lactobacillus rhamnosus meningitis following recurrent episodes of bacteremia in a child undergoing allogeneic hematopoietic stem cell transplantation. J Clin Microbiol. 2010 Nov;48(11):4317-9. doi: 10.1128/JCM.00250-10 [MEDLINE]
Lactobacillus rhamnosus bacteremia: an emerging clinical entity. Eur J Clin Microbiol Infect Dis. 2012 Sep;31(9):2469-80. doi: 10.1007/s10096-012-1599-5 [MEDLINE]
Lactobacillus rhamnosus GG supplementation for preventing respiratory infections in children: a meta-analysis of randomized, placebo-controlled. Indian Pediatr. 2013 Apr;50(4):377-81 [MEDLINE]
Rapid adoption of Lactobacillus rhamnosus GG for acute gastroenteritis. Pediatrics. 2013 Mar;131 Suppl 1:S96-102. doi: 10.1542/peds.2012-1427l [MEDLINE]
Severe oral infection due to Lactobacillus rhamnosus during induction chemotherapy for acute myeloid leukemia. Int J Hematol. 2014 Dec;100(6):607-10. doi: 10.1007/s12185-014-1650-7 [MEDLINE]
Probiotic-associated aspiration pneumonia due to Lactobacillus rhamnosus. J Clin Microbiol. 2014 Aug;52(8):3124-6. doi: 10.1128/JCM.01065-14 [MEDLINE]
Lactobacillus rhamnosus bacteremia in a kidney transplant recipient. Transpl Infect Dis. 2015 Aug;17(4):610-2. doi: 10.1111/tid.12410 [MEDLINE]
Breakthrough Lactobacillus rhamnosus GG bacteremia associated with probiotic use in an adult patient with severe active ulcerative colitis: case report and review of the literature. Infection. 2015 Dec;43(6):777-81. doi: 10.1007/s15010-015-0798-2 [MEDLINE]