Analysis of Clinical and Microbiological Features of Listeria monocytogenes Infection

Abstract

Introduction

To analyze the demographics and clinical features of 59 cases of Listeria monocytogenes, and determine the predisposing conditions for severe meningitis infections for reference.

Materials and methods

A total of 59 cases isolated L. monocytogenes from 2009 to 2020 were enrolled. Electronic medical record data were used to determine the epidemiological and clinical characteristics of L. monocytogenes infection. Univariate and multifactorial logistic regression analyses were performed to predict risk factors for Listeria meningitis.

Results

A total of 59 cases (median age of 52 years, 30 females and 29 males) were enrolled. Twenty-five patients (42.37%) developed a neuroinvasive infection. The indexes of interleukin-6 (IL-6), CD3+T, CD4+T, and CD8+T cells in the study group were higher than those in the control group (P<0.05). In univariate analysis, the use of hormone drugs (odds ratio=3.21, P=0.000) and immunosuppressive agents (odds ratio=3.06, P=0.000) were relevant predictors of severe meningitis. 47 patients (79.66%) were treated with ampicillin (27.12%), carbapenems (18.64%), quinolones (11.86%), and β-lactamase inhibitors (11.86%) as the primary agents of antimicrobial therapy. Thirty-four patients (57.63%) showed clinical improvement, five patients (8.47%) had a poor prognosis, and two patients (3.39%) died.

Conclusion

Infection with Listeria changed the levels of IL-6, CD3+T, CD4+T, and CD8+T cells, and these analyzing items were significantly different between L. monocytogenes and other bacterial infections. Long-term use of immunosuppressants and hormones may be risk factors for severe adult forms of Listeria-related infections. Sensitive antibiotics, such as penicillins and carbapenems, should be added or replaced in the early empiric treatment of L. monocytogenes.

Keywords:

• Listeria monocytogenes
• sepsis
• meningitis
• antimicrobials
• clinical and laboratory characteristics

Ethics Statement

The protocol was approved by the Ethics Review Committee of West China Hospital, Sichuan University (reference: 20191116). All subjects gave written informed consent in accordance with the Declaration of Helsinki. The subjects’ rights were adequately protected, and there was no potential risk to the subjects.

Acknowledgments

The authors would like to thank all the patients who participated in this research.

Author Contributions

Xingbing Lu and Huan Yang shared the first authorship. All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflict of interest.

Additional information

Funding

No funding to report.