Healthcare-associated bacteraemia caused by Leuconostoc species at a university hospital in Taiwan between 1995 and 2008

SummaryWe studied twenty patients with Leuconostoc spp. bacteraemia at a tertiary hospital in northern Taiwan between 1995 and 2008. All isolates were identified to species level using conventional and commercial automated methods in conjunction with 16S rRNA sequencing analysis. Leuconostoc lactis (15/20, 75%) constituted the most common species but required molecular methods for accurate identification. Minimum inhibitory concentrations (MICs) of 10 antimicrobial agents were determined using the broth microdilution method. Among these 20 patients, 19 had healthcare-associated Leuconostoc spp. bacteraemia and 11 patients (55%) had underlying malignancies. Eleven had been hospitalised for more than 30 days (median: 32.5 days; range: 0–252 days) before the bacteraemic episode. At the time of bacteraemia, 11 had a Pitt bacteraemia score of ≥4 (median: 4; range: 0–7) and 12 had a modified Acute Physiological Assessment and Chronic Health Evaluation (APACHE II) score of ≥20 (median: 22; range: 5–37). Azithromycin (MIC: 0.12 μg/mL), moxifloxacin (MIC: 0.25–0.5 μg/mL), daptomycin (MIC: 0.03–0.25 μg/mL) and tigecycline (MIC: 0.06–0.12 μg/mL) exhibited good in vitro activity against Leuconostoc spp. although bacteraemia due to L. lactis was associated with high mortality in immunocompromised patients.