Related Experiment Videos
Listeroisis in immunosuppressed patients. A cluster of eight cases
Abstract:
Bactermia due to listeria monocytogenes developed in eight patients who were receiving immunosuppresive medications during a 15 month period at one hospital. Seven survived. Meningitis was documented in only the four who received kidney transplants. Their neurologic signs were minimal, indicating a need to treat any immunosuppressed patient with Listeria bacteremia for meningitis. During this period the incidence of Listeria bactermia in immunosuppressed patients greatly exceeded that previously observed in this hospital or reported elsewhere, but the incidence of infection with other opportunistic agents was not increased. As with previously decreased listeria outbreaks in nonimmunosuppressed patients, no source or mechanism of spread could be identified. Thus, disease due to L. monocytogenes may occur focally among immunosuppressed populations, a pattern which also appears to be emerging for other opportunistic agents. A patient's exposure to different opportunistic agents may be as important as the kind of immunosuppressive therapy he recieves in determining which opportunistic infection he will acquire or even whether any infection will occur.
Insights
Immunosuppressed patients are at high risk for Listeria monocytogenes bacteremia and meningitis. Early treatment for meningitis is crucial, even with minimal neurologic signs, in these vulnerable populations.
Area of Science:
- Infectious Diseases
- Immunology
- Nephrology
Background:
- Listeria monocytogenes (L. monocytogenes) infections can occur in immunosuppressed individuals.
- The incidence of Listeria bacteremia in immunosuppressed patients can be focal and may exceed previously reported rates.
- Opportunistic infections in immunosuppressed patients are influenced by various factors, including exposure to pathogens and type of immunosuppressive therapy.
Purpose of the Study:
- To investigate the occurrence and characteristics of Listeria monocytogenes bacteremia in immunosuppressed patients.
- To determine the incidence of meningitis in patients with Listeria bacteremia.
- To highlight the importance of considering meningitis in all immunosuppressed patients with Listeria bacteremia.
Main Methods:
- Retrospective case series analysis of immunosuppressed patients.
- Review of medical records for diagnosis of Listeria bacteremia and meningitis.
- Comparison of incidence rates with historical data.
Main Results:
- Eight cases of Listeria monocytogenes bacteremia occurred in immunosuppressed patients over 15 months.
- Seven of the eight patients survived.
- Meningitis was diagnosed in four kidney transplant recipients, with minimal neurologic signs.
Conclusions:
- Any immunosuppressed patient with Listeria bacteremia should be treated for meningitis, regardless of neurologic signs.
- Listeria monocytogenes infections can occur focally in immunosuppressed populations.
- Patient exposure to opportunistic agents may be as critical as immunosuppressive therapy in determining infection risk.