Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.
Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medicine College, New Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
J Microbiol Immunol Infect. 2020 Dec;53(6):866-874. doi: 10.1016/j.jmii.2019.08.001. Epub 2019 Aug 21.
Neonatal listeriosis is a major cause of mortality in newborn; however, there is limited information about this disease in Taiwan. The aim of our study was to identify the outcome determinants, clinical features, and incidence of pregnancy-associated listeriosis, which includes both neonatal and maternal listeriosis.
We retrospectively analyzed the medical records of neonatal and maternal patients with pregnancy-associated listeriosis at two hospitals in Taiwan from January 2000 to December 2018. Listeriosis was indicated by positive Listeria monocytogenes culture.
Our study examined 18 neonates and 19 mothers. The neonatal and fetal death rate was 24%. All five cases of fetal losses or neonatal deaths occurred before 29 weeks of gestational age. The annual incidence of confirmed neonatal listeriosis increased significantly from 0.94/10,000 neonatal inpatients in 2000-2011 to 5.45/10,000 neonatal inpatients in 2012-2018 (p = 0.026). Clinical presentations of neonatal listeriosis included respiratory distress (85%), leukocytosis or leukopenia (77%), bandemia (69%), thrombocytopenia (77%), hypocalcemia (100%) and elevated C-reactive protein (CRP) levels (92%). Lower gestation correlated with a higher fatality rate (p = 0.002). Among the maternal cases investigated, 67% had a diagnosis of listeriosis, and 72% presented with fever. However, only 21% of the 19 mothers received complete antepartum ampicillin treatment.
The incidence of neonatal listeriosis is increasing, especially in preterm neonates. Maternal listeriosis should be adequately treated with appropriate empirical antibiotics.
新生儿李斯特菌病是新生儿死亡的主要原因；然而，关于这种疾病在台湾的信息有限。我们的研究目的是确定与妊娠相关李斯特菌病（包括新生儿李斯特菌病和产妇李斯特菌病）的结局决定因素、临床特征和发病率。
我们回顾性分析了台湾两家医院 2000 年 1 月至 2018 年 12 月期间与妊娠相关的李斯特菌病的新生儿和产妇患者的病历。李斯特菌病通过阳性李斯特菌属培养物来指示。
我们的研究共检查了 18 名新生儿和 19 名母亲。新生儿和胎儿死亡率为 24%。所有五例胎儿丢失或新生儿死亡均发生在 29 周妊娠龄之前。确诊新生儿李斯特菌病的年发病率从 2000-2011 年的每 10000 名新生儿住院患者中 0.94 例显著增加到 2012-2018 年的 5.45 例（p=0.026）。新生儿李斯特菌病的临床特征包括呼吸窘迫（85%）、白细胞增多或白细胞减少（77%）、血中出现幼稚粒细胞（69%）、血小板减少（77%）、低钙血症（100%）和 C 反应蛋白（CRP）水平升高（92%）。较低的胎龄与更高的死亡率相关（p=0.002）。在所研究的产妇病例中，67%的产妇被诊断为李斯特菌病，72%的产妇出现发热。然而，仅有 19 名母亲中的 21%接受了完整的产前氨苄西林治疗。
新生儿李斯特菌病的发病率正在增加，尤其是在早产儿中。应适当用适当的经验性抗生素治疗产妇李斯特菌病。
