Listeria monocytogenes bacteraemia. Review of 19 cases
Abstract number: R2434
Granados A., Font B., Navarro M., Fontanals D., Segura F.
Objectives: To analyse the epidemiologic and clinical features of bacteraemia caused by Listeria monocytogenes (LM) in a general hospital and review of the literature
Methods: We reviewed the medical and laboratory records of all patients diagnosed of LM bacteraemia between January 1996 and September 2007. Inclusion criteria were: adults (older than 18 years old), with blood positive cultures for LM without symptoms or signs of infection in other regions.
Results: 19 patients were recruited, 58% were men. Mean age 61 years (range 2794). 12 (63%) were older than 60 years of age. The incidence has increased from 1 case in 1996 to a maximum of 5 cases in 2003. Only 4 patients (21%) were not immunocompromised, but all of them were older than 60 years. The most frequent immunocompromising conditions were: pregnancy 3 cases, non-haematological malignancies (4), haematological malignancies (3), immunosuppressive treatment (2), and steroids treatment (4). The clinical picture was fever in 10 cases (53%) and chills in 5 patients (27%). 75% of patients presented symptoms for less than 2 days before hospital admission (mean 2 days, range 07). Mean time between admission and diagnosis was 1.7 days (range 13). The 3 cases associated to pregnancy manifested in the third trimester with fever and abdominal pain. All of them lead to premature birth, but only one newborn was infected.
Mean time between admission and treatment was 1.8 days (range 13). The majority of patients, 15 cases (79%) received an antilisterial treatment (Ampicillin 13 patients, in 4 cases associated with gentamicin and one case associated with cotrimoxazole, amoxicillin-clavulanic acid 2 patients). Ceftriaxone was the first treatment in one patient. 3 patients died before receiving any treatment. Mean duration of treatment was 18 days (range 131). Mortality rate was 42.1% (8 cases), 3 patients directly attributed to LM infection. Mortality rate between patients receiving an antilisterial treatment was 27%. Mean survival was 14 days (range 330).
Conclusion: LM bacteraemia incidence is increasing, probably caused by the increase in the number of patients with immunosuppressant conditions and the increase in life expectancy. In the elderly or immunocompromised patients with symptoms suggesting bacteraemia without symptoms or signs of infection in other regions LM infection must be suspected and an empirical treatment with an antilisterial drug must be administered as soon as possible.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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