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[Five cases of listeriosis in the elderly]
T Nakajima1, M Kodaira, Y Masuda
1Department of Infectious Disease, Tokyo Metropolitan Geriatric Hospital.
Abstract:
We reported five cases of listeriosis (sepsis and meningitis) in the elderly in our hospital during the last 4 years, where no cases of listeriosis had been found. These 5 cases had diabetes mellitus, lung cancer, chronic respiratory failure, gastric ulcer and aplastic anemia respectively as their underlying diseases. At the onset of listeriosis, 3 cases received corticosteroid and 3 cases received H2-blocker. 2 patients were cured and 3 patients died. Three autopsy cases had meningitis or meningoencephalitis and 2 cases of these autopsy cases had granulomatous changes in these spleens. In serotypes of Listeria monocytogenes (L. monocytogenes), 4 cases were 4b and 1 cases was 1b. All 5 strains were resistant to 3rd generation cephems. Wide uses of 3rd generation cephems and H2-blocker may be one of the reasons for the recent increase of listeriosis. Ingestion of contaminated food is the pathogenetic mechanism for initiating L. monocytogenes infections. And following the change of eating habits and the increase of imported foods, food-born listeriosis may increase. We suppose the increase of L. monocytogenes infections and must give attention to L. monocytogenes infections.
Insights
Elderly patients experienced severe Listeria monocytogenes infections, including sepsis and meningitis, despite no prior cases. Increased use of certain medications and changing food habits may contribute to this rise in listeriosis.
Area of Science:
- Infectious Diseases
- Geriatric Medicine
- Microbiology
Background:
- Listeriosis is a serious infection caused by Listeria monocytogenes.
- The elderly population with comorbidities is particularly vulnerable.
Observation:
- Five cases of listeriosis (sepsis and meningitis) occurred in elderly patients over four years.
- Underlying conditions included diabetes, lung cancer, respiratory failure, gastric ulcer, and aplastic anemia.
- Three patients received corticosteroids, and three received H2-blockers at the onset of infection.
Findings:
- Two patients recovered, while three died.
- Autopsies revealed meningitis or meningoencephalitis, with two cases showing splenic granulomatous changes.
- All Listeria monocytogenes strains were serotypes 4b or 1b and resistant to third-generation cephalosporins.
Implications:
- Widespread use of third-generation cephalosporins and H2-blockers may be linked to increased listeriosis incidence.
- Changes in dietary habits and increased consumption of imported foods could contribute to foodborne listeriosis.
- Heightened awareness and surveillance for Listeria monocytogenes infections are crucial, especially in vulnerable populations.