Trends in listeriosis in a university hospital (19832007)
Abstract number: P1613
Davila C., Prim N., Pedro-Botet M.L., Sopena N., Giménez M., Mòdol J.M., García-Núñez M., Roure S., Sabria M.
Infection caused by Listeria is acquired by the ingestion of contaminated food which has increased in recent years due to the frequent use of ready-made meals. This, together with a longer life expectancy of patients with chronic diseases and a large number of immunosuppressed patients, are factors which may explain the apparent increase in the incidence of listeriosis.
Objectives: To know the risk factors and clinical aspects of infection by Listeria and evaluate epidemiological changes over time.
Methods: We retrospectively reviewed the cases of listeriosis reported in the Department of Microbiology from 1983 to 2007. Patients were arbitrarily classified into 2 groups: group 1 from 1983 to 1995 and group 2: from 1996 to 2007.
Results: 72 patients (21 group1; 49 group 2) with listeriosis were included. 56.9% (41/72) were males with a mean age of 53.8 years (087). The mean age rose significantly in group 2. 10% (7/70) were hospital-acquired, being significantly greater in group 1.Underlying diseases were present in 81.9% (59/72), including chronic liver disease (34.3%), alcoholism (28.6%) and cancer (28.6%) and with a significant increase in heart diseases and cancer and a decrease in HIV patients in group 2. 30% (21/70) and 28.5% (20/70) were receiving corticoids and immunosuppressive therapy respectively, with an increase, albeit not significant, in group 2. Previous diarrhoea was reported in 7 cases (10%). 7.4% (5/68) were pregnant women, 83.6% (56/68) presented with sepsis, 44.8% (30/67) had meningoencephalitis and 7.3% (5/) focal infections. Blood culture was positive in 79.1% (57/72) as was CSF culture in 40.2% (29/72). Serotype 4 was the most prevalent but a significant increase in serotype 1 was observed in group 2. 20.6% (14/68) required ICU admission and mortality was 20.9%, with a non significant increase in group 2.
Conclusions: Cases of listeriosis have increased in the last decade due to a rise in sepsis. At present, chronic liver disease continues to be the most important risk factor, although an increase in the number of cases with heart disease and cancer receiving immunosuppressive therapy is of note. In the last decade, mortality has shown a trend to an increase and has reached a value of 24%.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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