From the School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand and National Health Laboratory Services, Johannesburg, South Africa .
Pediatr Infect Dis J. 2021 Oct 1;40(10):917-921. doi: 10.1097/INF.0000000000003213.
Infection due to Listeria monocytogenes (LM) is rare in neonates; thus, its clinical presentation and outcomes are not commonly reported, especially in low- and middle-income countries. In 2017, South Africa had an outbreak due to LM.
To determine demographic characteristics, clinical and laboratory findings and outcomes of all neonates infected with LM during the outbreak period.
This is a retrospective analytic study. Clinical and laboratory records of neonates admitted at Chris Hani Baragwanath Academic Hospital from January 2017 to May 2018 with positive blood and cerebrospinal fluid culture with LM were reviewed for demographic characteristics, clinical presentation, ancillary laboratory test results and outcomes at hospital discharge.
There were 42 neonates with positive cultures due to LM. Thirty-four (81%) were born preterm. Mode of delivery was vaginal in 78.6% and 31.0% were HIV exposed. All patients presented within the first 6 days of life as an early-onset disease. Common clinical presentation was respiratory depression (52.4%) and respiratory distress (38.1%) with 69% requiring invasive or noninvasive respiratory support. Common abnormal laboratory findings were high C-reactive protein (77.1%) followed by leukopenia (23.8%). Fourteen patients (40%) had features of meningitis based on blood and cerebrospinal fluid findings (4 culture proven). There were 11 deaths at hospital discharge, giving a mortality rate of 26.2%.
The majority of neonates infected with LM were born preterm, raising the possibility that LM itself may have been responsible for preterm labor. All presented in the first 6 days of life and most presented with respiratory distress or depression. A high proportion had meningitis, and there was a high-mortality overall.
李斯特菌（LM）感染在新生儿中较为罕见；因此，其临床表现和结局并不常见，尤其是在中低收入国家。2017 年，南非发生了一起李斯特菌暴发事件。
确定暴发期间所有感染李斯特菌的新生儿的人口统计学特征、临床和实验室检查结果及结局。
这是一项回顾性分析研究。对 2017 年 1 月至 2018 年 5 月在克里斯·哈尼·巴哈纳特学术医院住院且血和脑脊液培养阳性的李斯特菌感染新生儿的临床和实验室记录进行了回顾性分析，内容包括人口统计学特征、临床表现、辅助实验室检查结果和出院时的结局。
有 42 例新生儿的培养物为李斯特菌阳性。34 例（81%）为早产儿。分娩方式为阴道分娩的占 78.6%，31.0%为 HIV 暴露儿。所有患者均在出生后 6 天内出现早发型疾病。常见的临床表现为呼吸抑制（52.4%）和呼吸窘迫（38.1%），69%需要有创或无创呼吸支持。常见的异常实验室发现是 C 反应蛋白升高（77.1%），其次是白细胞减少（23.8%）。根据血液和脑脊液检查（4 例培养阳性），14 例（40%）患者有脑膜炎特征。出院时共有 11 例死亡，死亡率为 26.2%。
感染李斯特菌的新生儿多数为早产儿，这提示李斯特菌本身可能导致早产。所有患儿均在出生后 6 天内发病，多数表现为呼吸窘迫或呼吸抑制。很大一部分患儿有脑膜炎，总体死亡率较高。
