From the Research
Lactobacillus delbrueckii in a urine culture should be considered a potential pathogen, particularly in elderly patients or those with underlying comorbidities, and treated with β-lactams, such as aminopenicillins, if clinical and biological signs of infection are present. According to the most recent and highest quality study 1, Lactobacillus delbrueckii subspecies allosunkii and lactis have been identified as emerging human uropathogens in elderly patients. This study demonstrates that L. delbrueckii can cause true urinary tract infections, especially in patients with significant cultures (≥105 CFU/mL) and positive direct examination.
The study 1 found that the majority of L. delbrueckii isolates were susceptible to most antibiotics, especially β-lactams, and recommends their use for treatment. In contrast to previous beliefs, Lactobacillus species are not always considered contaminants in urine samples, and their presence can indicate a true infection, particularly in predisposed patients.
Key points to consider:
- Lactobacillus delbrueckii can cause urinary tract infections, especially in elderly patients or those with underlying comorbidities 1
- β-lactams, such as aminopenicillins, are recommended for treatment 1
- Good collection technique, including thorough genital cleaning before providing a midstream sample, is essential to determine if the presence of Lactobacillus delbrueckii in a urine culture is a true infection or contamination
- Consultation with an infectious disease specialist may be warranted if the patient is symptomatic and repeat cultures continue to show only Lactobacillus 2, 3, 4