Yeon-Joo Choi, Jaehyuk Kim, Sang-Oh Lee, Heungsup Sung, Sang-Ho Choi
Leuconostoc bacteremia most often occurred as a hospital-acquired infection and frequently originated from the abdomen. Virulence appeared limited, and adverse outcomes were predominantly driven by concomitant infection rather than Leuconostoc itself.
PURPOSE: Leuconostoc species are rare opportunistic pathogens with intrinsic resistance to glycopeptides. However, the clinical characteristics, outcomes, and prognostic factors of Leuconostoc bacteremia in adults remain poorly defined. We aimed to characterize adult patients with Leuconostoc bacteremia and identify factors associated with 30-day mortality.
METHODS: We conducted a retrospective cohort study of adult patients with Leuconostoc bacteremia at a 2,700-bed tertiary-care hospital between 1997 and 2024. Demographic, clinical, and microbiological characteristics were analyzed descriptively. Sepsis and septic shock were defined according to the Sepsis-3 criteria. Factors associated with 30-day mortality were assessed using multivariable logistic regression.
RESULTS: A total of 129 adults were included. Solid cancer was the most common underlying disease (51.2%), and 75.2% of episodes were hospital-acquired. Monomicrobial and polymicrobial bacteremia occurred in 53.5% and 46.5% of cases, respectively. Most patients with monomicrobial bacteremia had no clinical evidence of sepsis (81.2%), whereas polymicrobial bacteremia was associated with a higher frequency of septic shock (2.9% vs. 20.0%, p < 0.01). The abdomen was the most common portal of entry (49.6%), followed by an unknown source (41.9%) and intravascular catheter-related infection (7.8%). Only one case of infective endocarditis was identified (0.8%). Among monomicrobial cases, 30-day mortality was 13.0% and bacteremia-related mortality was 2.9%. In multivariable analysis, polymicrobial bacteremia was the only independent predictor of 30-day mortality (adjusted odds ratio, 4.30; 95% CI, 1.60-11.60).
CONCLUSION: Leuconostoc bacteremia most often occurred as a hospital-acquired infection and frequently originated from the abdomen. Virulence appeared limited, and adverse outcomes were predominantly driven by concomitant infection rather than Leuconostoc itself.