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Treatment failure and recurrent human listeriosis
J McLauchlin1, A Audurier, A G Taylor
1PHLS Division of Microbiological Reagents and Quality Control, Central Public Health Laboratory, Colindale, London, UK.
Abstract:
We review 12 patients and report an additional two new patients, each of whom had two episodes of listeriosis. In seven patients the two episodes were due to the same strain of Listeria monocytogenes, and we speculate that this was a reactivation of the original infection. In one patient, isolates of L. monocytogenes from the two episodes differed, suggesting a chance reinfection. Twelve of the patients in this series received inappropriate therapy. Ampicillin plus an aminoglycoside for three to four weeks remain the treatment of choice.
Insights
Recurrent listeriosis can occur due to reinfection or reactivation of Listeria monocytogenes. Ampicillin plus an aminoglycoside for 3-4 weeks is the recommended treatment for this serious infection.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Recurrent listeriosis, while uncommon, presents unique diagnostic and therapeutic challenges.
- Listeriosis is a serious infection caused by Listeria monocytogenes, particularly concerning in vulnerable populations.
Purpose of the Study:
- To analyze cases of recurrent listeriosis to understand causative factors and optimal treatment strategies.
- To evaluate the efficacy of current treatment protocols for recurrent Listeria monocytogenes infections.
Main Methods:
- Retrospective review of 12 patients with recurrent listeriosis.
- Case report of 2 additional patients with dual episodes of listeriosis.
- Analysis of Listeria monocytogenes strains from initial and subsequent episodes.
Main Results:
- Fourteen patients experienced two episodes of listeriosis.
- Seven patients had recurrent infections caused by the same Listeria monocytogenes strain, suggesting reactivation.
- One patient's recurrent infection was due to a different strain, indicating reinfection.
- Twelve patients received inappropriate initial therapy.
Conclusions:
- Recurrent listeriosis can stem from either endogenous reactivation or exogenous reinfection.
- Appropriate and timely antimicrobial therapy is crucial for managing listeriosis.
- A treatment regimen of ampicillin combined with an aminoglycoside for three to four weeks remains the standard of care.