Streptococcus lactis isolated from a patient with subacute bacterial endocarditis

doi:10.1016/0002-9343(55)90247-3

The American Journal of Medicine

Volume 18, Issue 2, February 1955, Pages 345-347

https://doi.org/10.1016/0002-9343(55)90247-3 Get rights and content

Abstract

A case of subacute bacterial endocarditis caused by Streptococcus lactis is described. An organism similar to that cultured from the blood of the patient was also isolated from a sample of the brand of sour cream which this patient had eaten abundantly prior to his illness. The portal of entry of the Strep, lactis was probably through the irritated gum surrounding a nonvital first lower right molar tooth. This probability is consistent with the findings of Elliott that streptococci serologically identical with those cultured from the gums can be obtained on blood culture following even such mild procedures as slight trauma to the gum or “rocking” a tooth in its socket.⁹

References (9)

C.C. Okell et al.
Bacteriaemia and oral sepsis with special reference to the aetiology of subacute endocarditis
Lancet
(1935)
F.R. Selbie et al.
Serological classification of viridans streptococci from subacute bacterial endocarditis, teeth, and throats
Brit. M. J.
(1949)
M. Solowey
A serological classification of viridans streptococci with special reference to those isolated from subacute bacterial endocarditis
J. Exper. Med.
(1942)
V. Wagner
Pathogenicity of Streptococcus lactis
Schweiz. Ztschr f. Bact. u. Path.
(1944)

There are more references available in the full text version of this article.

Cited by (32)

Lactococcus lactis cremoris intra-uterine infection: About an uncommon case report
2022, International Journal of Surgery Case Reports
Citation Excerpt :
Concerning risk factors, some authors have suggested that immunocompromised subjects are more susceptible to the disease; however, we found only 26% of the cases, including ours, with a compromised immune status [4,10,19,21,27,30]. Although the evidence for increased susceptibility of pregnant women to infection is quite weak, immunological alterations during this period may impair pathogen clearance [31]. Therefore, we chose to include them in cases of compromised immunity.
When intra-uterine infection (IUI) is suspected or confirmed, intravenous antibiotic therapy providing coverage against common organisms (S. agalactiae and E. coli) is recommended to be administered immediately in order to reduce the risk of maternal and neonatal infectious complications. Nevertheless, it happens that some infections are due to uncommon microorganisms that do not respond to probabilistic treatment. Therefore, samples with bacteriological examination remain systematic. Moreover, the extraperitoneal cesarean section avoids the opening of the peritoneal cavity used in the Pfannenstiel technique and thus reduces the risk of infectious dissemination.
We hereby present the uncommon case of a 19-year-old primigravida woman who was referred to our facility for acute gastroenteritis at 34 weeks of gestation. The hospital course was complicated by premature rupture of the membranes followed by the development of fever, chills and deterioration of the fetal heart rate (FHR), imposing an urgent extraperitoneal cesarean section for suspected IUI with fetal impact. Bacteriological examination of a placental sample subsequently yielded growth of Lactococcus lactis cremoris which makes it to our knowledge the second case reported to date of an IUI due to this bacterium.
IUI predominantly occurs by ascending bacterial invasion from the lower genital tract to the typically sterile amniotic cavity in the setting of membrane rupture. Extraperitoneal cesarean section serves as a viable alternative to classic transperitoneal delivery in the presence of uterine infection by controlling bacterial spread.
Our case serves as a reminder that IUI can arise from multiple pathogens, including Lactococcus lactis cremoris which is known as a harmless bacterium.
Lactococcus lactis cholangitis and bacteremia identified by MALDI-TOF mass spectrometry: A case report and review of the literature on Lactococcus lactis infection
2019, Journal of Infection and Chemotherapy
Citation Excerpt :
None of the 8 cases of endocarditis involved immunocompromised patients [2–9]. Three cases had intracardiac anatomical abnormalities (rheumatic fever, atrial myxoma, and mitral valve repair) [2,4,9], while one case had undergone root canal treatment before the onset of endocarditis [3]. Exposure to raw milk or unpasteurized dairy products are known to be risk factors for L. lactis infection.
Lactococcus lactis is a rare causative organism in humans. Cases of L. lactis infection have only rarely been reported. However, because it is often difficult to identify by conventional commercially available methods, its incidence may be underestimated. We herein report the case of a 70-year-old man with cholangiocarcinoma who developed L. lactis cholangitis and review previously reported cases of L. lactis infection. Our case was confirmed by matrix-assisted desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). This case shows L. lactis is a potential causative pathogen of cholangitis and that MALDI-TOF MS can be useful for the rapid and accurate identification of L. lactis infection. We searched the literature for published case reports on cholangitis and any other infections caused by L. lactis, and thereby identified 36 cases, including our case. At least 66.7% (n = 24) of the cases had significant underlying conditions; 15 of the cases involved patients with an immunocompromised status. At least 41.7% (n = 15) had a significant food consumption history, such as the consumption of unpasteurized dairy products. The clinical sources of L. lactis were diverse and endocarditis was the most common diagnosis (n = 8), followed by hepatobiliary infection (n = 6), central nervous system infection (n = 5), and peritonitis (n = 4). The prognosis was favorable in most cases.
Safety assessment of dairy microorganisms: The Lactococcus genus
2008, International Journal of Food Microbiology
The Lactococcus genus includes 5 species. Lactococcus lactis subsp. lactis is the most common in dairy product but L. garviae has been also isolated. Their biotope is animal skin and plants. Owing to its biochemical characteristics, strains of L. lactis are widely used in dairy fermented products processing. Cases of human infections due to lactococci are very seldom reported even if Lactococcus garviae can be involved in fish diseases. Then L. lactis can be considered as safe and it is most commonly considered as Generally Recognized as Safe.
Lactococcus lactis: an opportunistic bacterium?
2007, Medecine et Maladies Infectieuses
Les bactéries lactiques sont utilisées depuis des siècles pour fermenter les aliments et ainsi, mieux les conserver. Réputées inoffensives pour l'homme, leur usage s'est largement répandu dans l'industrie alimentaire. Certaines souches ont même été envisagées pour le traitement de maladies humaines. En effet, le développement de nouvelles technologies de biologie cellulaire ouvre une perspective d'utilisation de ces bactéries comme agents biothérapeutiques. Ces souches produiraient des protéines hétérogènes telles que des enzymes (lipase, lactase, estérase), des médiateurs chimiques (hormones et interleukines) et des molécules pouvant stimuler une réponse immunitaire locale. Toutefois, de rares cas d'infection, plus ou moins sévères, sont rapportés chez l'homme. Elles surviennent généralement sur un terrain fragilisé par une pathologie sous-jacente. Une consommation de produits laitiers non pasteurisés est invoquée chez certains d'entre eux. La rareté des cas et leur pronostic favorable ne doivent pas remettre en cause l'intérêt industriel et médical de ces bactéries.
Lactic bacteria have been used for centuries to ferment food and thus, to better preserve them. Considered as inoffensive for man, its use has largely spread in food industry. Some species are even being considered for the treatment of human diseases. Indeed, the development of new cellular biology technologies opens opportunities for the use of these bacteria as biotherapeutic agents. These species would produce heterogeneous proteins such as enzymes (lipase, lactase, esterase), chemical mediators (hormones and interleukins), and molecules able to stimulate local immune responses. However, rare cases of human infection, sometimes severe, were reported recently. They generally occured in patients with comorbidities with consumption of unpasteurized dairy products reported for some. The scarcity of these cases and their favorable outcome should not hinder the industrial and medical use of these bacteria.
Endocarditis caused by Lactococcus lactis subsp. lactis in a patient with atrial myxoma: a case report
2006, Diagnostic Microbiology and Infectious Disease
Lactococcus garvieae endocarditis: Identification by 16S rRNA and sodA sequence analysis
2006, Journal of Infection

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^☆: From The Hospital of the Rockefeller Institute for Medical Research, New York, N. Y.

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Case reportStreptococcus lactis isolated from a patient with subacute bacterial endocarditis☆

Abstract

Lancet

Serological classification of viridans streptococci from subacute bacterial endocarditis, teeth, and throats

Brit. M. J.

A serological classification of viridans streptococci with special reference to those isolated from subacute bacterial endocarditis

J. Exper. Med.

Pathogenicity of Streptococcus lactis

Schweiz. Ztschr f. Bact. u. Path.

Case report
Streptococcus lactis isolated from a patient with subacute bacterial endocarditis☆