Maertens De Noordhout C, Devleesschauwer B, Maertens De Noordhout A, Blocher J, Haagsma J A, Havelaar A H, Speybroeck N
Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte B1.30.15, Brussels, 1200, Belgium.
Ghent University, Merelbeke, Belgium.
BMC Infect Dis. 2016 Jun 7;16:256. doi: 10.1186/s12879-016-1602-3.
Listeriosis is a rare disease caused by the bacterium Listeria monocytogenes and mainly affects at risk people. Listeriosis can lead to sepsis, central nervous system (CNS) infections and death. The objectives of this study were to describe and quantify comorbidities and neurological sequelae underlying non-perinatal listeriosis cases and to describe the factors associated with death and CNS infections in non-perinatal listeriosis.
We retrospectively collected clinical data through computerized, paper or microfilmed medical records in two Belgian university hospitals. Logistic regression models and likelihood ratio tests allowed identifying factors associated with death and CNS infections.
Sixty-four cases of non-perinatal listeriosis were included in the clinical case series and 84 % were affected by at least one comorbid condition. The main comorbidities were cancer, renal and severe cardio-vascular diseases. Twenty-nine patients (45 %) suffered from a CNS infection and 14 patients (22 %) died during hospitalization, among whom six (43 %) had a CNS involvement. Among surviving patients, eleven suffered from neurological sequelae (22 %) at hospital discharge; all had CNS infection. Five of these patients (45 %) still suffered of their neurological sequelae after a median follow-up of one year (range: 0.08-19). The factor associated with death during the hospitalization was the presence of a severe cardiovascular disease (OR = 4.72, p = 0.015). Two factors inversely related with CNS infections were antibiotic monotherapy (OR = 0.28, p = 0.04) and the presence of renal disease (OR = 0.18, p = 0.02).
In a public health context these results could be a starting point for future burden of listeriosis studies taking into account comorbidity.
李斯特菌病是一种由单核细胞增生李斯特菌引起的罕见疾病，主要影响高危人群。李斯特菌病可导致败血症、中枢神经系统（CNS）感染和死亡。本研究的目的是描述和量化非围产期李斯特菌病病例潜在的合并症和神经后遗症，并描述非围产期李斯特菌病中与死亡和中枢神经系统感染相关的因素。
我们通过比利时两家大学医院的计算机化、纸质或缩微胶片病历回顾性收集临床数据。逻辑回归模型和似然比检验有助于确定与死亡和中枢神经系统感染相关的因素。
64例非围产期李斯特菌病病例纳入临床病例系列，84%的患者至少患有一种合并症。主要合并症为癌症、肾脏疾病和严重心血管疾病。29例患者（45%）发生中枢神经系统感染，14例患者（22%）在住院期间死亡，其中6例（43%）有中枢神经系统受累。在存活患者中，11例（22%）出院时患有神经后遗症；均有中枢神经系统感染。其中5例患者（45%）在中位随访一年（范围：0.08 - 19）后仍有神经后遗症。住院期间与死亡相关的因素是存在严重心血管疾病（OR = 4.72，p = 0.015）。与中枢神经系统感染呈负相关的两个因素是抗生素单药治疗（OR = 0.28，p = 0.04）和存在肾脏疾病（OR = 0.18，p = 0.02）。
在公共卫生背景下，这些结果可能是未来考虑合并症的李斯特菌病负担研究的起点。
