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Imaging InlC Secretion to Investigate Cellular Infection by the Bacterial Pathogen Listeria monocytogenes
Published on: September 19, 2013
[Spontaneous bacterial peritonitis caused by Listeria monocytogenes: eight case reports (1992-2017) and literature
M Fernández Torres1, I Angulo López, P Ruiz Bueno
1Marina Fernández Torres. Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla 25, 39008 Santander, Cantabria. Spain. marina.f.torres@outlook.com.
Objective:
Spontaneous bacterial peritonitis (SBP) is a frequent and severe entity in patients with cirrhosis or ascites due to other causes. However, Listeria monocytogenes is a microorganism that has been scarcely identified as a causative agent of SBP.
Methods:
In this study, a descriptive analysis of cases of L. monocytogenes SBP was carried out in our center for 26 years (1992-2017).
Results:
A total of eight patients were diagnosed, with an average age of 58 years, with no differences in sex distribution and all of them were community acquired cases. Half of the patients had underlying liver disease, two of them active malignancies; one was undergoing continuous ambulatory peritoneal dialysis and the last one with hypertensive heart disease. Six (75%) of the patients received a third-generation cephalosporin as empirical treatment. The clinical course was favorable after receiving directed antibiotic treatment in five (62.5%) of the patients. However, three of them, under the age of 59, died. Serotyping of L. monocytogenes isolates revealed that half of them were serovar 4, two 1 / 2a and the remaining one 1 / 2c. All strains were susceptible to ampicillin, meropenem, erythromycin and cotrimoxazole.
Conclusions:
We conclude by emphasizing the importance of taking this etiology into account in patients with underlying liver disease and with clinical or laboratory data suggesting SBP, mainly due to the need for specific antibiotic treatment different from conventionally empirically used.
Insights
Listeria monocytogenes is a rare cause of spontaneous bacterial peritonitis (SBP) in patients with liver disease. Early diagnosis and specific antibiotic treatment are crucial for favorable outcomes, as conventional empirical therapies may be ineffective.
Area of Science:
- Infectious Diseases
- Hepatology
- Microbiology
Background:
- Spontaneous bacterial peritonitis (SBP) is a common complication in patients with cirrhosis.
- Listeria monocytogenes is an uncommon pathogen identified in SBP cases.
Purpose of the Study:
- To analyze cases of Listeria monocytogenes SBP over 26 years.
- To highlight the importance of considering L. monocytogenes in SBP diagnosis.
Main Methods:
- Descriptive analysis of L. monocytogenes SBP cases.
- Review of patient demographics, clinical course, and treatment.
Main Results:
- Eight patients diagnosed with L. monocytogenes SBP.
- Half had underlying liver disease; others had malignancies, dialysis, or heart disease.
- Five patients (62.5%) had favorable outcomes with directed antibiotics; three died.
Conclusions:
- L. monocytogenes should be considered in SBP, especially in patients with liver disease.
- Specific antibiotic treatment is necessary, differing from empirical therapies.
- Early diagnosis and targeted treatment improve patient survival.
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