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Updated: Aug 4, 2025

Measuring Bacterial Load and Immune Responses in Mice Infected with Listeria monocytogenes
12:50

Measuring Bacterial Load and Immune Responses in Mice Infected with Listeria monocytogenes

Published on: August 9, 2011

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Adjunctive dexamethasone treatment in adults with listeria monocytogenes meningitis: a prospective nationwide cohort

Matthijs C Brouwer1, Diederik van de Beek1

  • 1Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.

Eclinicalmedicine
|April 3, 2023
PubMed
Abstract

Insights

Dexamethasone may improve outcomes for Listeria monocytogenes meningitis, contrary to previous guidelines. This study found dexamethasone treatment was linked to better results and lower mortality in patients with this specific bacterial meningitis.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Clinical Medicine

Background:

  • Previous French cohort studies suggested dexamethasone is detrimental in Listeria meningitis, leading to guidelines against its use.
  • Current guidelines recommend against using dexamethasone if Listeria monocytogenes is suspected or to discontinue it upon detection.

Purpose of the Study:

  • To investigate the clinical characteristics, treatment regimens, and outcomes of adults with Listeria monocytogenes meningitis.
  • To evaluate the effect of adjunctive dexamethasone on outcomes in a nationwide cohort of bacterial meningitis patients.

Main Methods:

  • A prospective nationwide cohort study in the Netherlands from January 1, 2006, to July 1, 2022.
  • Assessed 162 adults with community-acquired Listeria monocytogenes meningitis.
  • Used logistic regression to identify predictors of unfavorable outcome (Glasgow Outcome Scale 1-4) and mortality.

Main Results:

  • Listeria monocytogenes caused 6% of 2664 bacterial meningitis episodes.
  • Adjunctive dexamethasone was administered to 58% of patients.
  • Dexamethasone treatment was independently associated with a significantly improved outcome (adjusted OR 0.40; 95% CI 0.19-0.81) and reduced mortality.

Conclusions:

  • Adjunctive dexamethasone is associated with improved outcomes in Listeria monocytogenes meningitis.
  • Dexamethasone should not be withheld when Listeria monocytogenes is suspected or confirmed.
  • Findings challenge existing guidelines regarding dexamethasone use in Listeria meningitis.
Keywords:
Bacterial meningitisDexamethasoneListeria monocytogenesPrognosis

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