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Listeriosis in infants: Prospective surveillance studies in Canada and Switzerland
Bahaa Abu-Raya1, Marianne Jost2, Julie A Bettinger1
1Vaccine Evaluation Center, British Columbia Children's Hospital, Department of Pediatrics, Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia,Canada.
Insights
Neonatal listeriosis is rare in Canada and Switzerland, with most infant cases presenting early. This suggests empiric antibiotic coverage for listeriosis in sepsis may not always be needed after the first month of life.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Listeriosis in infants is a serious concern.
- International data is needed to inform antibiotic guidelines for infant sepsis.
Purpose of the Study:
- Determine the incidence, clinical features, and outcomes of listeriosis in infants under six months in Canada and Switzerland.
- Provide data to guide empiric antibiotic treatment recommendations.
Main Methods:
- Prospective, active surveillance of listeriosis in infants <6 months.
- Data collected via the Canadian Paediatric Surveillance Program and the Swiss Paediatric Surveillance Unit.
- Inclusion of confirmed and probable cases.
Main Results:
- Low incidence reported: 1.1/100,000 live births/year in Canada and 4.5/100,000 live births/year in Switzerland.
- Most cases (66.6%) were early-onset (within 7 days of life).
- No cases presented after 28 days of life; some Swiss cases were linked to an outbreak.
Conclusions:
- Neonatal listeriosis is infrequent.
- Empiric antibiotic coverage for listeriosis in infants with sepsis may not be routinely necessary after the first month of life.
- Outbreaks can still occur, highlighting the need for ongoing surveillance.
Objectives:
International data on listeriosis during infancy from large populations are essential to guide evidence-based empiric antibiotic guidelines for sepsis in infancy. We aimed to determine the incidence, clinical manifestations, and outcome of listeriosis in infants <6 months of age in Canada and Switzerland.
Methods:
Prospective, active surveillance of listeriosis in infants <6 months of age was conducted through the Canadian Paediatric Surveillance Program (May 2015 to April 2017) and the Swiss Paediatric Surveillance Unit (April 2017 to March 2018). Confirmed and probable cases were included.
Results:
In Canada, eight sporadic listeriosis cases were reported (incidence, 1.1/100,000 live births/year). In Switzerland, four cases were reported (incidence, 4.5/100,000 live births/year) of which three were part of a confirmed outbreak with an unclear source. In the two countries, eight of the 12 cases (66.6%) presented as early-onset disease (within the first 7 days of life) and none presented after 28 days life.
Conclusions:
Neonatal listeriosis is rare. Infants presenting with sepsis, especially after 4 weeks of life, may not routinely require empiric antibiotic coverage for listeriosis. Outbreak-related cases still occur. Continued surveillance is important.
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