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Listeria monocytogenes infections: Analysis of 41 patients
Blanca N Beamonte Vela1, Rafael Garcia-Carretero2, Blanca Carrasco-Fernandez3
1Rey Juan Carlos University, Spain.
Insights
Severe Listeria monocytogenes infections are uncommon but dangerous, particularly in newborns and pregnant women. Neurological involvement significantly increases the risk of severe illness, though not necessarily mortality, in listeriosis cases.
Area of Science:
- Infectious Diseases
- Epidemiology
- Clinical Microbiology
Background:
- Listeria monocytogenes (L. monocytogenes) can cause severe infections, including sepsis and mortality, particularly in vulnerable populations.
- Understanding the demographics and clinical features of listeriosis is crucial for identifying predisposing factors for severe outcomes.
Purpose of the Study:
- To analyze Listeria-related demographics and clinical features.
- To determine predisposing conditions for severe L. monocytogenes infections.
- To investigate the role of neurological involvement in severe listeriosis.
Main Methods:
- Retrospective study of patients with positive Listeria monocytogenes isolation from sterile sites.
- Analysis of electronic health records for epidemiological and clinical data.
- Statistical analysis to identify risk factors for severe infection and mortality.
Main Results:
- A 15-year study (2003-2018) identified an annual incidence of 1.3 cases per 100,000 population.
- Key affected groups included newborns (17.1%), pregnant women (12.2%), and other adults (82.9%).
- Neuroinvasive infections (41.5% of cases) were the primary risk factor for severe listeriosis (OR 1.8, p=0.01), but not mortality.
Conclusions:
- Listeriosis, though uncommon, poses a significant risk of severe sepsis and mortality, especially in susceptible groups.
- Neurological involvement is a critical risk factor for severe invasive listeriosis.
- While neuroinvasive forms increase severity, they were not found to be a significant predictor of mortality in this study.
Objective:
We describe and analyze Listeria-related demographics and clinical features to determine the predisposing conditions for severe infections.
Methods:
We performed a retrospective study using positive isolation of Listeria monocytogenes from blood, cerebrospinal fluid, and other organic fluids. Electronic health records were used to determine the epidemiological and clinical features of infections caused by L. monocytogenes. Mortality and sepsis were considered dependent variables in the statistical analyses.
Results:
We included 41 patients in an observation period of 15 years (2003-2018), with an annual incidence rate of 1.3 cases per 100,000 population. Three main population profiles were identified: newborns, pregnant women, and other adults (17.1%, 12.2%, and 82.9%, respectively). Neuroinvasive infection was present in 17 patients (41.5%). In both univariate and multivariate analyses, neurological infections, whether meningoencephalitis, rhombencephalitis, or brain abscesses, were the main risk factors for severe forms of Listeria-related infections (odds ratio 1.8, 95% CI 1.52-2.14, p=0.01). Malignancies, whether solid tumors or hematological neoplasms, immunosuppression, and chronic diseases were not related to either mortality or severe clinical syndromes.
Conclusion:
Infections caused by L. monocytogenes were uncommon but could cause severe sepsis and mortality, especially in susceptible populations. Our study focused on neurological involvement and severe invasive forms of listeriosis. Neuroinvasive forms were the most important risk factors for severe illness but not for mortality.
