[Listeria monocytogenes meningitis in children in France].

UNLABELLED

Listeriosis is a serious invasive disease which affects mainly pregnant women, newborns and immunocompromised adults.

OBJECTIVE

To analyze specifically the epidemiological and clinical data of the meningitis due to Listeria monocytogenes (Lm), from the French Network of Surveillance of Bacterial Meningitis in childhood.

PATIENTS AND METHODS

Patients were aged 0 to 18 years. The diagnosis was based on a combination of a feverish meningeal syndrome and a positive culture of cerebrospinal fluid (CSF) and/or a positive PCR in the CSF and/or positive blood culture associated with a pleiocytose.

RESULTS

Among 2539 cases of bacterial meningitis recorded in 6 years (2001 to 2006), 18 cases were due to Lm (0.7 %) (sex ratio M / F : 0.8). The average of age was 2.5 years (median : 0.5 ; ext : 0-15.1). The serotype of Lm was 4B in half of the cases. Most cases have occured in summer and autumn. Two patients presented an acquired or congenital immunodeficiency. Fifty-six percent (n=10) were younger than 1 year, among them, 7 were newborns. The CSF direct microbiologic investigation was suggestive of Lm (Gram positive bacilli) only in two cases, but the culture of CSF was positive for 16 patients and the blood culture was positive for 2 other patients. Three of 18 patients died between 7 and 13 days after admittance : a premature baby of 25 weeks'gestational age, two full-term newborns of 2 days and 1.5 months old. The mortality rate was 16.7 % before the age of 1 year (no death after this age).

CONCLUSION

Meningitis due to Lm remains a rare disease, including in neonatal period. The recent increase of cases in adults requires to maintain vigilance in children especially since direct examination of CSF can rarely allow the diagnosis.