Gellin B G, Broome C V, Bibb W F, Weaver R E, Gaventa S, Mascola L
Division of Bacterial Diseases, Centers for Disease Control, Atlanta, GA.
Am J Epidemiol. 1991 Feb 15;133(4):392-401. doi: 10.1093/oxfordjournals.aje.a115893.
To determine the morbidity and mortality due to listeriosis in the United States, the authors undertook an active surveillance project in 1986 to identify all cases in which Listeria monocytogenes was isolated from cultures of ordinarily sterile sites in a population of 34 million persons. The authors estimated that at least 1,700 cases of listeriosis and 450 deaths occurred in the United States in 1986; 27% of these cases occurred in pregnant women, with 22% of perinatal cases resulting in stillbirths or neonatal deaths. The risk of listeriosis in adults (0.5 per 100,000 population) was similar in all regions studied; the incidence of perinatal listeriosis was three times higher in Los Angeles County, California, than in the other areas (24.3/100,000 live births vs. 7.8/100,000 live births). Geographic variation may have resulted from underdiagnosis of perinatal listeriosis in five of the study areas. Multilocus electrophoretic enzyme typing was useful for elucidating the molecular epidemiology of L. monocytogenes; perinatal listeriosis was significantly associated with one group of related strains. Multilocus electrophoretic enzyme typing also identified three clusters representing possible common-source outbreaks. These findings document the substantial morbidity due to listeriosis in the United States; to the extent that sporadic listeriosis is foodborne, this morbidity could be reduced by appropriate preventive measures, particularly in persons known to be at increased risk of infection.
为确定美国李斯特菌病的发病率和死亡率，作者于1986年开展了一项主动监测项目，以识别在3400万人群中从通常无菌部位的培养物中分离出单核细胞增生李斯特菌的所有病例。作者估计，1986年美国至少发生了1700例李斯特菌病病例和450例死亡；其中27%的病例发生在孕妇中，围产期病例中有22%导致死产或新生儿死亡。在所有研究地区，成年人李斯特菌病的风险（每10万人中有0.5例）相似；加利福尼亚州洛杉矶县围产期李斯特菌病的发病率比其他地区高3倍（24.3/10万活产儿 vs. 7.8/10万活产儿）。地理差异可能是由于五个研究地区围产期李斯特菌病诊断不足所致。多位点电泳酶分型有助于阐明单核细胞增生李斯特菌的分子流行病学；围产期李斯特菌病与一组相关菌株显著相关。多位点电泳酶分型还识别出三个集群，代表可能的共同来源暴发。这些发现证明了美国李斯特菌病造成的大量发病情况；就散发性李斯特菌病是食源性的而言，通过适当的预防措施，特别是在已知感染风险增加的人群中，可以降低这种发病率。
