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Am J Perinatol 2009; 26(1): 089-091
DOI: 10.1055/s-0028-1103025
© Thieme Medical Publishers

Leuconostoc Septicemia in a Preterm Neonate on Vancomycin Therapy: Case Report and Literature Review

Ginger Janow1 , Binta Lambert1 , 2 , Melissa Scheiner1 , 2 , Orna Rosen1 , 2 , David L. Goldman1 , 3 , Lamia Soghier1 , 2
  • 1Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York
  • 2Division of Neonatology, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York
  • 3Division of Infectious Disease, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York
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Publication History

Publication Date:
21 November 2008 (online)

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ABSTRACT

We report the case of a 26-day-old premature infant born at 24 weeks' gestation who developed septicemia while receiving vancomycin therapy. The blood isolate initially identified as a vancomycin-resistant Streptococcous viridans was found to be Leuconostoc spp. Her condition improved with parenteral ampicillin and gentamicin therapy and removal of the intravenous central catheter. Prematurity is a recognized risk factor for Leuconostoc disease. Clinicians need to consider Leuconostoc spp. when vancomycin-resistant pathogens are identified and provide appropriate therapy.

KEYWORDS

Leuconostoc - preterm - neonate - septicemia - vancomycin-resistant - streptococcus

REFERENCES

  • 1 Green M, Wadowsky R M, Barbadora K. Recovery of vancomycin-resistant gram-positive cocci from children.  J Clin Microbiol. 1990;  28 484-488
    PubMedSearch in Google Scholar
  • 2 Park H K, Shim S S, Kim S Y et al.. Molecular analysis of colonized bacteria in a human newborn infant gut.  J Microbiol. 2005;  43 345-353
    PubMedSearch in Google Scholar
  • 3 Handwerger S, Horowitz H, Coburn K, Kolokathis A, Wormser G P. Infection due to Leuconostoc species: six cases and review.  Rev Infect Dis. 1990;  12 602-610
    PubMedSearch in Google Scholar
  • 4 Friedland I R, Snipelisky M, Khoosal M. Meningitis in a neonate caused by Leuconostoc sp.  J Clin Microbiol. 1990;  28 2125-2126
    PubMedSearch in Google Scholar
  • 5 Uko S, Soghier L M, Vega M et al.. Targeted short-term fluconazole prophylaxis among very low birth weight and extremely low birth weight infants.  Pediatrics. 2006;  117 1243-1252
    CrossrefPubMedSearch in Google Scholar
  • 6 Handwerger S, Pucci M J, Volk K J, Liu J, Lee M S. Vancomycin-resistant Leuconostoc mesenteroides and Lactobacillus casei synthesize cytoplasmic peptidoglycan precursors that terminate in lactate.  J Bacteriol. 1994;  176 260-264
    PubMedSearch in Google Scholar
  • 7 Dhodapkar K M, Henry N K. Leuconostoc bacteremia in an infant with short-gut syndrome: case report and literature review.  Mayo Clin Proc. 1996;  71 1171-1174
    CrossrefPubMedSearch in Google Scholar
  • 8 Hardy S, Ruoff K L, Catlin E A, Ignacio Santos J. Catheter-associated infection with a vancomycin-resistant gram-positive coccus of the Leuconostoc sp.  Pediatr Infect Dis J. 1988;  7 519-520
    PubMedSearch in Google Scholar
  • 9 Helali A, McAlear D, Osoba A. Leuconostoc bacteremia in a child with short-gut syndrome.  Saudi Med J. 2005;  26 311-313
    PubMedSearch in Google Scholar
  • 10 Carapetis J, Bishop S, Davis J, Bell B, Hogg G. Leuconostoc sepsis in association with continuous enteral feeding: two case reports and a review.  Pediatr Infect Dis J. 1994;  13 816-823
    PubMedSearch in Google Scholar
  • 11 Rubin L G, Vellozzi E, Shapiro J, Isenberg H D. Infection with vancomycin-resistant “streptococci” due to Leuconostoc species.  J Infect Dis. 1988;  157 216
    PubMedSearch in Google Scholar
  • 12 Isenberg H D, Vellozzi E M, Shapiro J, Rubin L G. Clinical laboratory challenges in the recognition of Leuconostoc spp.  J Clin Microbiol. 1988;  26 479-483
    PubMedSearch in Google Scholar
  • 13 Monsen T, Granlund M, Olofsson K, Olsen B. Leuconostoc spp. septicaemia in a child with short bowel syndrome.  Scand J Infect Dis. 1997;  29 310-311
    PubMedSearch in Google Scholar
  • 14 Ling M L. Leuconostoc bacteraemia.  Singapore Med J. 1992;  33 241-243
    PubMedSearch in Google Scholar
  • 15 Coovadia Y M, Solwa Z, van Den Ende J. Potential pathogenicity of Leuconostoc.  Lancet. 1988;  1 306
    PubMedSearch in Google Scholar
  • 16 Golledge C L. Infection due to Leuconostoc species.  Rev Infect Dis. 1991;  13 184-185
    PubMedSearch in Google Scholar
  • 17 Casanova-Román M, Rios J, Sánchez-Porto A, Gomar J L, Casanova-Bellido M. Leuconostoc bacteremia in a healthy infant.  Minerva Pediatr. 2003;  55 83-86
    PubMedSearch in Google Scholar
  • 18 Noriega F R, Kotloff K L, Martin M A, Schwalbe R S. Nosocomial bacteremia caused by Enterobacter sakazakiki and Leuconostoc mesenteroides resulting from extrinsic contamination of infant formula.  Pediatr Infect Dis J. 1990;  9 447-449
    PubMedSearch in Google Scholar
  • 19 Barry H, Clancy M T, Brady A, O'Higgins N. Isolation of a Leuconostoc species from a retroareolar breast abscess.  J Infect. 1993;  27 208-210
    CrossrefPubMedSearch in Google Scholar
  • 20 Swenson J M, Facklam R R, Thornsberry C. Antimicrobial susceptibility of vancomycin-resistant Leuconostoc, Pediococcus, and Lactobacillus species.  Antimicrob Agents Chemother. 1990;  34 543-549
    PubMedSearch in Google Scholar
  • 21 Buu-Hoï A, Branger C, Acar J F. Vancomycin-resistant streptococci or Leuconostoc sp.  Antimicrob Agents Chemother. 1985;  28 458-460
    PubMedSearch in Google Scholar

Dr. Lamia Soghier

Division of Neonatology, Department of Pediatrics, Albert Einstein College of Medicine

Children's Hospital at Montefiore

Email: lsoghier@montefiore.org