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Listeria monocytogenes meningitis in the Netherlands, 1985-2014: A nationwide surveillance study
Merel M Koopmans1, Merijn W Bijlsma1, Matthijs C Brouwer1
1Department of Neurology, Academic Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.
Objectives:
Listeria monocytogenes can cause sepsis and meningitis. We report national surveillance data on L. monocytogenes meningitis in the Netherlands, describing incidence changes, genetic epidemiology and fatality rate.
Methods:
We analyzed data from the Netherlands Reference Laboratory of Bacterial Meningitis for cases of L. monocytogenes meningitis. Strains were assessed by serotyping and bacterial population structure by multi-locus sequence typing.
Results:
A total of 375 cases of Listeria meningitis were identified between 1985 and 2014. Peak incidence rates were observed in neonates (0.61 per 100,000 live births) and older adults (peak at 87 year; 0.53 cases per 100,000 population of the same age). Neonatal listerial meningitis decreased 17-fold from 1.95 per 100,000 live births between 1985 and 1989, to 0.11 per 100,000 live births between 2010 and 2014. Overall case fatality rate was 31%, in a multivariate analysis older age and concomitant bacteremia were associated with mortality (both p < 0.01). Clonal complexes (CC) CC1, CC2 and CC3 decreased over time from respectively 32% to 12%, 33% to 9% and 10% to 2% (all p < 0.001), while CC6 increased from 2% to 26% (p < 0.001).
Conclusions:
The incidence of neonatal listerial meningitis has declined over the past 25 years. The genotype CC6 has become the predominant genotype in listerial meningitis in the Netherlands. Mortality of listeria meningitis has remained high.
Insights
Neonatal Listeria meningitis incidence has significantly decreased in the Netherlands. However, Listeria meningitis mortality remains high, with genotype CC6 now predominant.
Area of Science:
- Infectious Diseases
- Epidemiology
- Bacteriology
Background:
- Listeria monocytogenes is a significant cause of sepsis and meningitis.
- Understanding the epidemiology and genetic landscape of Listeria monocytogenes meningitis is crucial for public health interventions.
Purpose of the Study:
- To analyze national surveillance data on Listeria monocytogenes meningitis in the Netherlands.
- To describe changes in incidence, genetic epidemiology, and fatality rates over a 25-year period.
Main Methods:
- Analysis of national surveillance data from the Netherlands Reference Laboratory of Bacterial Meningitis (1985-2014).
- Serotyping and multi-locus sequence typing (MLST) were used to assess bacterial strains and population structure.
Main Results:
- A total of 375 cases were identified, with peak incidence in neonates and older adults.
- Neonatal listerial meningitis incidence decreased 17-fold; overall case fatality rate was 31%.
- Clonal complex CC6 emerged as the predominant genotype, while CC1, CC2, and CC3 decreased.
Conclusions:
- The incidence of neonatal Listeria meningitis has declined significantly.
- Genotype CC6 is now the dominant cause of Listeria meningitis in the Netherlands.
- Mortality associated with Listeria meningitis remains a critical public health concern.
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