Infectious Disease Compendium

Lactobacillus

Microbiology

Anaerobic gram positive rod found in the colon, oral cavity and vagina.

Epidemiologic Risks

Normal flora of gut (minor constituent) and female genital tract (major constituent). The lactobacilli in yogurt and probiotics are not the same strains found in and on the human body. The epidemiologic data does not suggest the lactobacilli in our food cause disease, the molecular biology is less forgiving (PubMed).

Bacteremia is ususally from lines or abdominal sepsis and are, in order of likelyhood,  Lactobacillus salivarius , followed by Lactobacillus paracasei  and Lactobacillus fermentum (PubMed).

Usually the bacteremia is NOT from probiotics.

Syndromes

Occasional endocarditis, UTI and other infections where a body fluid goes into what should be a sterile space.

L. rhamnosus is a cause of bacteremia, often from lines and the immunoincompetent (PubMed).

Treatment

Ampicillin, erythromycin, tetracycline. Add aminoglycoside if endocarditis.

For bacteremic infections, "Minimum inhibitory concentrations were highest for glycopeptides, cephalosporins and fluoroquinolones and were lowest for carbapenems and aminopenicillins (PubMed)."

Notes

Lactobacilli are resistant to vancomycin and often resistant to the cephalosporins and quinolones. As to their therapeutic use see probiotics.