Department of Medical and Surgical Sciences, Infectious and Tropical Diseases Unit, "Magna Graecia" University, Catanzaro, Italy; Research and Development Department, Chelsea and Westminster Hospital Foundation Trust, London, United Kingdom.
Institute of Neurology, "Magna Graecia" University, Catanzaro, Italy.
Infez Med. 2020 Jun 1;28(2):258-262.
Few cases of complicated infections with Listeria monocytogenes (LM) have been reported to date in patients with multiple sclerosis (MS) treated with alemtuzumab. Primary prevention strategies may be suggested in such patients to avoid infections. However, these may be ineffective because patients may already be carriers of LM. We report herein a case of bloodstream infection due to LM in a 25-year-old woman with MS treated with alemtuzumab. We searched the UMC/WHO Vigibase system for all reported cases of LM in patients treated with alemtuzumab and found 29 cases overall up to 21 July 2019. We also performed a literature review of MS cases with LM on alemtuzumab, in order to evaluate epidemiology, clinical characteristics, and outcome of this complication. Since the published cases (N=8) were mainly reported in recent years but more cases were found in the UMC/WHO Vigibase system (although not necessarily in patients with MS), we hypothesize that this complication is more frequent than currently believed and may become even more important in the future. Therefore, it is worth reaching a consensus on appropriate algorithms to stratify individuals by risk so as to implement targeted prevention strategies (whether primary or secondary).
迄今为止，已有少数几例报道称，在接受阿仑单抗治疗的多发性硬化症（MS）患者中，出现李斯特菌（LM）感染的复杂病例。在这些患者中可能会建议采取初级预防策略来避免感染。然而，这些策略可能无效，因为患者可能已经是 LM 的携带者。我们报告了一例 25 岁女性 MS 患者在接受阿仑单抗治疗后发生 LM 血流感染的病例。我们检索了 UMC/WHO Vigibase 系统中所有接受阿仑单抗治疗的患者中报告的 LM 病例，截至 2019 年 7 月 21 日，共发现 29 例。我们还对阿仑单抗治疗的 MS 合并 LM 的病例进行了文献复习，以评估该并发症的流行病学、临床特征和结局。由于已发表的病例（N=8）主要是近年来报告的，但 UMC/WHO Vigibase 系统中发现的病例更多（尽管并非一定是 MS 患者），因此我们假设这种并发症比目前认为的更为常见，在未来可能会变得更加重要。因此，值得就分层个体风险的适当算法达成共识，以便实施有针对性的预防策略（无论是初级预防还是二级预防）。
