Elbeldi A, Smaoui H, Hamouda S, Helel S, Hmaied F, Ben Mustapha I, Barsaoui S, Bousnina S, Marrakchi Z, Barbouche M R, Kechrid A
Laboratoire de Microbiologie, Hôpital d'Enfants de Tunis, Tunis, Tunisie.
Bull Soc Pathol Exot. 2011 Feb;104(1):58-61. doi: 10.1007/s13149-010-0110-8. Epub 2010 Dec 20.
Listeria monocytogenesis a Gram positive facultative intracellular bacterium that can be responsible for severe infections, affecting essentially pregnant women, immunocompromised patients at the early and later stages of life. In Tunisia, invasive L. monocytogenes infections are thought to be exceptional and limited data are available about listeriosis. We reported seven cases (five newborn children and two infants) of human listeriosis that occurred in Tunis from 2000 to 2008. The newborn children were hospitalized for suspicion of maternofoetal infections. The two infants were hospitalized for fever associated with digestive signs in one case and neurological signs in the other. L. monocytogenes-was isolated from culture of cerebrospinal fluid in four cases, peripheral samples in two cases and from blood culture in one case. Isolates identification was based on conventional methods. Antimicrobial susceptibility was realized according to the recommendation of the "Comité de l'antibiogramme de la Société française de microbiologie". All L. monocytogenes isolates were sensitive to amoxicillin and aminoside but resistant to 3rd generation cephalosporins. Investigations of the immune system were realized for the two infants including phenotypic analysis of peripheral blood cells by flow cytometry, lymphocyte proliferation assays, phagocytic cell functions and measurement of immunoglobulins as well as complement. All these explorations were normal for both infants. The outcome was fatal in only one case (a newborn child), and all the other patients recovered after adapted antibiotic treatment. In conclusion, our study shows that listeriosis is not exceptional in Tunis. Thus, it is necessary to know how to evoke this diagnosis, at any age, in order to establish an early and adapted antibiotic treatment and to avoid fatal outcome.
单核细胞增生李斯特菌是一种革兰氏阳性兼性胞内细菌，可导致严重感染，主要影响孕妇以及生命早期和晚期的免疫功能低下患者。在突尼斯，侵袭性单核细胞增生李斯特菌感染被认为较为罕见，关于李斯特菌病的可用数据有限。我们报告了2000年至2008年在突尼斯发生的7例人类李斯特菌病病例（5例新生儿和2例婴儿）。新生儿因疑似母婴感染而住院。2例婴儿中，1例因发热伴消化症状住院，另1例因神经系统症状住院。4例脑脊液培养、2例外周样本培养和1例血培养分离出单核细胞增生李斯特菌。分离株鉴定基于传统方法。根据“法国微生物学会抗菌谱委员会”的建议进行药敏试验。所有单核细胞增生李斯特菌分离株对阿莫西林和氨基糖苷类敏感，但对第三代头孢菌素耐药。对2例婴儿进行了免疫系统检查，包括通过流式细胞术对外周血细胞进行表型分析、淋巴细胞增殖试验、吞噬细胞功能以及免疫球蛋白和补体的测量。这2例婴儿的所有这些检查均正常。仅1例（1名新生儿）预后不良，其他所有患者经适当抗生素治疗后康复。总之，我们的研究表明，李斯特菌病在突尼斯并非罕见。因此，有必要知道如何在任何年龄段考虑这一诊断，以便尽早进行适当的抗生素治疗并避免致命后果。
