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Updated: Mar 16, 2026
Listeria monocytogenes Infection of the Brain
Published on: October 2, 2018
Predictive risk factors for Listeria monocytogenes meningitis compared to pneumococcal meningitis: a multicenter
Seungjin Lim1,2, Doo Ryeon Chung3, Yeon-Sook Kim4
1Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
Purpose:
Various immunocompromised conditions increase the risk of meningitis caused by Listeria monocytogenes. However, the relative importance of these risk factors has not been well established. We determined the risk factors that predict meningitis due to L. monocytogenes compared to that caused by Streptococcus pneumoniae.
Methods:
A nationwide multicenter case-control study was conducted in Korea. Cases of meningitis caused by L. monocytogenes between 1998 and 2013 were included. Patients with pneumococcal meningitis were included as controls. Multivariate logistic regression analysis was used to predict the risk factors of Listeria meningitis.
Results:
A total of 36 cases and 113 controls were enrolled. The most significant predictive risk factor of Listeria meningitis was a prior history of receiving immunosuppressive therapy (odds ratio 8.12, 95 % CI 2.47-26.69). Chronic liver disease was the second most important predictive risk factor (OR 5.03, 95 % CI 1.56-16.22). Delaying appropriate antibiotic therapy by more than 6 h (hazard ratio 2.78) and fatal underlying disease (hazard ratio 2.88) were associated with increased mortality.
Conclusions:
Patients with a prior history of receiving immunosuppressive therapy within 1 month and chronic liver disease have 8.1-fold and 5-fold increased risk of meningitis by L. monocytogenes compared to S. pneumoniae, respectively.
Insights
Immunosuppressive therapy and chronic liver disease significantly increase the risk of Listeria monocytogenes meningitis compared to Streptococcus pneumoniae meningitis. These findings aid in identifying high-risk patients for early intervention.
Area of Science:
- Infectious Diseases
- Neurology
- Epidemiology
Background:
- Immunocompromised states elevate the risk of Listeria monocytogenes (LM) meningitis.
- The comparative significance of various risk factors for LM meningitis remains unclear.
Purpose of the Study:
- To identify and compare risk factors for LM meningitis versus Streptococcus pneumoniae (SP) meningitis.
- To establish the relative importance of immunocompromising conditions in predicting LM meningitis.
Main Methods:
- A nationwide, multicenter case-control study was conducted in Korea from 1998 to 2013.
- LM meningitis cases were compared with SP meningitis controls.
- Multivariate logistic regression analysis identified predictive risk factors.
Main Results:
- Thirty-six LM meningitis cases and 113 SP meningitis controls were analyzed.
- Prior immunosuppressive therapy was the strongest predictor (OR 8.12).
- Chronic liver disease was the second most significant factor (OR 5.03).
Conclusions:
- Patients on immunosuppressive therapy within one month face an 8.1-fold higher risk of LM meningitis.
- Chronic liver disease confers a 5-fold increased risk for LM meningitis compared to SP meningitis.
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