{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T09:33:51Z","timestamp":1790760831503,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Management Expenses Grants from the Government of Japan to national university corporations"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Probiotics have been reported to be beneficial for the prevention of postoperative complications and are often used during the perioperative period. Among the probiotic-related adverse events, bacteremia is rare. Here, we report two cases of probiotic-related bacteremia after major hepatectomy for biliary cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation 1<\/jats:title>\n                    <jats:p>\n                      A 74-year-old man was referred to our hospital to be treated for gallbladder cancer. Neoadjuvant chemotherapy, two courses of gemcitabine plus S-1 combination therapy, was administered. Extended right hepatectomy with caudate lobectomy, extrahepatic bile duct resection and biliary reconstruction were performed 3\u00a0weeks after chemotherapy. Probiotics,\n                      <jats:italic>Clostridium butyricum<\/jats:italic>\n                      (\n                      <jats:italic>C. butyricum<\/jats:italic>\n                      ) MIYAIRI 588, were administered 6\u00a0days before surgery and continued after surgery. Sepsis of unknown origin occurred 17\u00a0days after surgery and developed into septic shock.\n                      <jats:italic>C. butyricum<\/jats:italic>\n                      was detected in blood cultures at postoperative day 26 and 45. After stopping the probiotic agent,\n                      <jats:italic>C. butyricum<\/jats:italic>\n                      was undetectable in the blood cultures. The patient died due to an uncontrollable sepsis 66\u00a0days after surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation 2<\/jats:title>\n                    <jats:p>\n                      A 63-year-old man with diabetes mellitus whose past history included total colectomy, papillectomy, and Frey\u2019s operation at the age of 19, 34 and 48, respectively, was referred to our hospital to be treated for perihilar cholangiocarcinoma. Extended left hepatectomy with caudate lobectomy, extrahepatic bile duct resection and reconstruction of bile duct were performed. Probiotics were administered during the perioperative period. Combined probiotics that included lactomin, amylolytic bacillus and\n                      <jats:italic>C. butyricum<\/jats:italic>\n                      , were given before surgery.\n                      <jats:italic>C. butyricum<\/jats:italic>\n                      MIYAIRI 588 was given after surgery. Sepsis occurred 16\u00a0days after surgery and developed to respiratory failure 8\u00a0days later. Blood culture at postoperative day 25 revealed\n                      <jats:italic>Enterococcus faecalis<\/jats:italic>\n                      and\n                      <jats:italic>C. butyricum<\/jats:italic>\n                      . After the probiotics were stopped at postoperative day 27,\n                      <jats:italic>C. butyricum<\/jats:italic>\n                      was not detected in the blood culture. The general condition improved with intensive care. The patient was transferred to another hospital for rehabilitation at postoperative day 156.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It should be noted that the administration of probiotics in severe postoperative complications can lead to probiotic-related bacteremia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40792-021-01216-5","type":"journal-article","created":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T03:26:05Z","timestamp":1622517965000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Probiotic-related bacteremia after major hepatectomy for biliary cancer: a report of two cases"],"prefix":"10.1186","volume":"7","author":[{"given":"Mitsuhiro","family":"Shimura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6436-5477","authenticated-orcid":false,"given":"Masamichi","family":"Mizuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Miura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuyuki","family":"Takadate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyohei","family":"Ariake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimpei","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kawaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiro","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaharu","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideo","family":"Ohtsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Morikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kamei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiaki","family":"Unno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,1]]},"reference":[{"key":"1216_CR1","unstructured":"FAO\/WHO. 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