Listeriosis: The Experience of a Portuguese Hospital Centre
Listeriose: A Experiência de um Centro Hospitalar Português
DOI:
https://doi.org/10.24950/rspmi.2515Keywords:
Listeria, Listeria monocytogenes, Listeriosis/complications, Listeriosis/diagnosis, Listeriosis/drug therapy, Listeriosis/epidemiologyAbstract
Introduction: Listeria spp. infection is rare. It usually results from the consumption of contaminated food. Although most cases are sporadic, outbreaks of food origin have been reported. The spectrum of clinical manifestations is diverse, particularly bacteriemia, sepsis, and central nervous system (CNS) infection. It mainly affects elderly patients with important comorbidities or immunosuppression states, and pregnant women. Mortality can reach 30%.
Material and Methods: We selected the specimens positive for strains of Listeria spp. using the laboratory informatic system database of our hospital center from 2013-2020. The patients’ corresponding processes were reviewed for demographic variables and clinical data as predisposing conditions, type of infection and outcome.
Results: Twenty-five cases of Listeria infection were identified, with a mean age of 66.6 years. Most individuals (92%) had some risk factor or predisposing condition, with the most frequent being age > 65 years (64%), followed by the use of proton pump inhibitors, diabetes, alcoholism, neoplasia, and immunosuppressive therapy. Nineteen cases of bacteriemia and 9 cases of CNS infection were observed, and focal forms such as endocarditis, spontaneous bacterial peritonitis and infected muscle hematoma were observed. Overall mortality was 16%. No patient with CNS infection has died. Only in one case was there a relationship with a possible food outbreak.
Conclusion: In our series, we found data similar to those in the literature, but we highlight the high percentage of patients with multiple predisposing conditions, less common focal forms, and the absence of mortality in patients with CNS infection. The analysis of our data allowed us to understand the importance of clarifying the source of infection, which is why we advise the use of a questionnaire regarding the consumption of suspicious food or an outbreak of food origin.
Downloads
References
Centers for Disease Control and Prevention (CDC). Vital signs: Listeria illnesses, deaths, and outbreaks--United States, 2009-2011. MMWR Morb Mortal Wkly Rep. 2013;62:448-52.
Jensen AK, Björkman JT, Ethelberg S, Kiil K, Kemp M, Nielsen EM. Molecular Typing and Epidemiology of Human Listeriosis Cases, Denmark, 2002-2012. Emerg Infect Dis. 2016;22:625-33. doi: 10.3201/eid2204.150998.
Hernandez-Milian A, Payeras-Cifre A. What is new in listeriosis? Biomed Res Int. 2014;2014:358051. doi: 10.1155/2014/358051.
Johnson JE, Mylonakis E. Listeria monocytogenes. In: Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia: Elsevier; 2019. p. 2543-49.
Bajard S, Rosso L, Fardel G, Flandrois JP. The particular behaviour of Listeria monocytogenes under sub-optimal conditions. Int J Food Microbiol. 1996;29:201-11. doi: 10.1016/0168-1605(95)00031-3.
Hohmann EL, Portnoy DA. Listeria monocytogenes Infections. In: Loscalzo J, Longo D, Kasper D, Hauser S, Jameson L, Fauci A, et al. Harrison’s Principles and Practice of Internal Medicine. 20th ed. New York: McGraw-Hill Education; 2018. Ch. 146.
Swaminathan B, Gerner-Smidt P. The epidemiology of human listeriosis. Microbes Infect. 2007;9:1236-43. doi: 10.1016/j.micinf.2007.05.011.
Hof H. Listeria monocytogenes: a causative agent of gastroenteritis? Eur J Clin Microbiol Infect Dis. 2001;20:369-73. doi: 10.1007/pl00011277.
Gelfand MS, Swamy GK, Thompson JL. Epidemiology and pathogenesis of Listeria monocytogenes infection. UpToDate [acedido jun 2023] Disponível:https://www.uptodate.com/contents/epidemiology-and-pathogenesis-of-listeria-monocytogenes-infection
Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, et al. Foodborne illness acquired in the United States--major pathogens. Emerg Infect Dis. 2011;17:7-15. doi: 10.3201/eid1701.p11101.
Freitag NE, Port GC, Miner MD. Listeria monocytogenes - from saprophyte to intracellular pathogen. Nat Rev Microbiol. 2009;7:623-8. doi: 10.1038/nrmicro2171.
Silk BJ, Date KA, Jackson KA, Pouillot R, Holt KG, Graves LM, et al. Invasive listeriosis in the Foodborne Diseases Active Surveillance Network (FoodNet), 2004-2009: further targeted prevention needed for higher-risk groups. Clin Infect Dis. 2012;54 Suppl 5:S396-404. doi: 10.1093/cid/cis268.
Charlier C, Perrodeau É, Leclercq A, Cazenave B, Pilmis B, Henry B, et al. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study. Lancet Infect Dis. 2017;17:510-9. doi: 10.1016/S1473-3099(16)30521-7.
Eckburg PB, Montoya JG, Vosti KL. Brain abscess due to Listeria monocytogenes: five cases and a review of the literature. Medicine. 2001;80:223-35. doi: 10.1097/00005792-200107000-00001.
Mylonakis E, Hohmann EL, Calderwood SB. Central nervous system infection with Listeria monocytogenes. 33 years' experience at a general hospital and review of 776 episodes from the literature. Medicine. 1998;77:313-36. doi: 10.1097/00005792-199809000-00002.
Brouwer MC, van de Beek D, Heckenberg SG, Spanjaard L, de Gans J. Community-acquired Listeria monocytogenes meningitis in adults. Clin Infect Dis. 2006;43:1233-8. doi: 10.1086/508462.
Gelfand MS, Swamy GK, Thompson JL. Clinical manifestations and diagnosis of Listeria monocytogenes infection. UpToDate [acedido jun 2023] Disponível: https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-listeria-monocytogenes-infection?
Gelfand MS, Thompson JL, Swamy GK. Treatment and prevention of Listeria monocytogenes infection. UpToDate [acedido jun 2023] Disponível: https://www.uptodate.com/contents/treatment-and-prevention-of-listeria-monocytogenes-infection
Cherubin CE, Appleman MD, Heseltine PN, Khayr W, Stratton CW. Epidemiological spectrum and current treatment of listeriosis. Rev Infect Dis. 1991;13:1108-14. doi: 10.1093/clinids/13.6.1108.
Kvistholm Jensen A, Simonsen J, Ethelberg S. Use of Proton Pump Inhibitors and the Risk of Listeriosis: A Nationwide Registry-based Case-Control Study. Clin Infect Dis. 2017;64:845-51. doi: 10.1093/cid/ciw860.
Armstrong RW, Fung PC. Brainstem encephalitis (rhombencephalitis) due to Listeria monocytogenes: case report and review. Clin Infect Dis. 1993;16:689-702. doi: 10.1093/clind/16.5.689.
Arias Miranda IM, Nuño Mateo FJ, Noval Menéndez J, Fonseca Aizpuru EM, Menéndez Calderón MJ. Listeriosis en el adulto. Revisión de 10 casos. An Med Interna. 2004;21:75-8. doi: 10.4321/s0212-71992004000200006.
Nolla-Salas J, Almela M, Gasser I, Latorre C, Salvadó M, Coll P. Spontaneous Listeria monocytogenes peritonitis: a population-based study of 13 cases collected in Spain. Am J Gastroenterol. 2002;97:1507-11. doi: 10.1111/j.1572-0241.2002.05798.x.
Spyrou N, Anderson M, Foale R. Listeria endocarditis: current management and patient outcome--world literature review. Heart. 1997;77:380-3. doi: 10.1136/hrt.77.4.380.
Summa C, Walker SA. Endocarditis Due to Listeria monocytogenes in an Academic Teaching Hospital: Case Report. Can J Hosp Pharm. 2010;63:312-4. doi: 10.4212/cjhp.v63i4.935..
Lorber B. Listeriosis. Clin Infect Dis. 1997;24:1-9; quiz 10-1. doi: 10.1093/clinids/24.1.1.
Angelo KM, Jackson KA, Wong KK, Hoekstra RM, Jackson BR. Assessment of the Incubation Period for Invasive Listeriosis. Clin Infect Dis. 2016;63:1487-9. doi: 10.1093/cid/ciw569.
Beach C. CDC reveals deadly outbreak traced to hard-boiled egg production plant. Food Safety News. 2019; 18.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 Internal Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
