Published online August 1, 2005
PEDIATRICS Vol. 116 No. 2 August 2005, pp. 517 (doi:10.1542/peds.2005-0475)
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Lactobacillus Sepsis Associated With Probiotic Therapy

Anjali N. Kunz, MD
Mary P. Fairchok, MD
Department of Pediatrics
Madigan Army Medical Center
Dupont, WA 98327

James M. Noel, MD
Department of Pediatrics
Brooke Army Medical Center
Fort Sam Houston, TX 78234

To the Editor.—

We read with interest the article by Land et al1 "Lactobacillus Sepsis Associated With Probiotic Therapy," which described 2 cases of Lactobacillus bacteremia after supplementation with Lactobacillus probiotic. However, they do not report the first cases of invasive disease resulting from the use of Lactobacillus probiotic as claimed in their article. We direct the authors to our article "Two Cases of Lactobacillus Bacteremia During Probiotic Treatment of Short Gut Syndrome,"2 which was published in April 2004. Our article describes 2 case reports of infants with short-gut syndrome who were treated with the probiotic Lactobacillus and subsequently developed bacteremia with species. As in the article by Land et al, we confirmed our findings of probiotic Lactobacillus bacteremia through pulse-gel electrophoresis in the case of one of our patients.

We agree with Land et al that these findings should not discourage appropriate use of probiotic supplements in selective patients, but vigilance should be maintained because of the possibility of subsequent sepsis. With the accumulation of more cases in the future, we may be better able to identify risk factors such as immature or inflamed gut epithelium in the case of premature infants. We hope that safe use of these probiotic supplements can continue with the provision of more informed consent regarding the potential risks.

REFERENCES

  1. Land MH, Rouster-Stevens K, Woods CR, Cannon ML, Cnota J, Shetty AK. Lactobacillus sepsis associated with probiotic therapy. Pediatrics. 2005;115 :178 –181[Abstract/Free Full Text]
  2. 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[ISI][Medline]
PEDIATRICS (ISSN 1098-4275). ©2005 by the American Academy of Pediatrics




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