Probiotics for preterm infants have been shown to reduce the incidence of necrotising enterocolitis and all-cause mortality in a recent meta-analysis. It has been argued, however, that some of these results may not be applicable to specific subgroups, e.g. infants with a birth weight of <1,000 g. The specific role of probiotics in improving health outcomes in preterm and term infants following intestinal surgery is not well defined. We report a case of a premature infant diagnosed with late-onset sepsis due to Lactobacillus rhamnosus following a laparotomy. We review pertinent published cases. This case highlights the importance of considering preterm infants as being at a higher risk of systemic probiotic infection following intestinal surgery.

Keywords:
Preterm infants, Sepsis, Probiotics, Lactobacillus, Laparotomy
1.
Collins MD, Phillips BA, Zanoni P: Deoxyribonucleic acid homology studies of Lactobacillus casei, Lactobacillus paracasei sp. nov., subsp. paracasei and subsp. tolerans, and Lactobacillus rhamnosus sp. nov., comb. nov. Int J Syst Bacteriol 1989;39:105-108.
2.
Felis GE, Dellaglio F: Taxonomy of lactobacilli and bifidobacteria. Curr Issues Intest Microbiol 2007;8:44-61.
3.
Tran L, Bégué RE, Penn D: Lactobacillus rhamnosus sepsis in an infant without probiotic use: a case report and literature review. J Neonat Perinat Med 2011;4:163-167.
4.
Al Faleh K, Anabrees J: Probiotics for prevention of necrotizing enterocolitis in preterm infants. Cochrane Database Syst Rev 2014;4:CD005496.
5.
Ohishi A, Takahashi S, Ito Y, Ohishi Y, Tsukamoto K, Nanba Y, Ito N, Kakiuchi S, Saitoh A, Morotomi M, Nakamura T: Bifidobacterium septicemia associated with postoperative probiotic therapy in a neonate with omphalocele. J Pediatr 2011;156:679-681.
6.
Land MH, Rouster-Stevens K, Woods CR, Cannon ML, Cnota J, Shetty AK: Lactobacillus sepsis associated with probiotic therapy. Pediatrics 2005;115:178-181.
7.
Kunz AN, Noel JM, Fairchok MP: Two cases of Lactobacillus bacteremia during probiotic treatment of short gut syndrome. J Pediatr Gastroenterol Nutr 2004;38:457-458.
8.
Zbinden A, Zbinden R, Berger C, Arlettaz R: Case series of Bifidobacterium longum bacteremia in three preterm infants on probiotic therapy. Neonatology 2015;107:56-59.
9.
Bertelli C, Pillonel T, Torregrossa A, Prod'hom G, Fischer CJ, Greub G, Giannoni E: Bifidobacterium longum bacteremia in preterm infants receiving probiotics. Clin Infect Dis 2015;60:924-927.
10.
Jenke A, Ruf EM, Hoppe T, Heldmann M, Wirth S: Bifidobacterium septicaemia in an extremely low-birthweight infant under probiotic therapy. Arch Dis Child Fetal Neonatal Ed 2012;97:F217-F218.
11.
Hickey L, Garland SM, Jacobs SE, O'Donnell CP, Tabrizi SN; ProPrems Study Group: Cross-colonization of infants with probiotic organisms in a neonatal unit. J Hosp Infect 2014;88:226-229.
12.
Reddy VS, Patole SK, Rao S: Role of probiotics in short bowel syndrome in infants and children - a systematic review. Nutrients 2013;5:679-699.
13.
Strunk T, Inder T, Wang X, Burgner D, Mallard C, Levy O: Infection-induced inflammation and cerebral injury in preterm infants. Lancet Infect Dis 2014;14:751-762.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.