Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
J Obstet Gynaecol Res. 2022 Jan;48(1):66-72. doi: 10.1111/jog.15063. Epub 2021 Oct 17.
To provide evidence for the diagnosis of listeriosis through a retrospective study of clinical features and results of pregnant women infected with listeriosis.
Twenty-nine pregnant women infected with listeriosis visiting West China Second University Hospital affiliated to Sichuan University from July 2010 to February 2019 were included in the retrospective analysis. Data like general information, clinical symptoms, laboratory results, and pathogen detection were analyzed to conclude clinical characteristics.
The median age of 29 patients was 28 (18.0-42.0). Nine individuals visited in the second trimester, while 20 in the last trimester. The median course before visiting was 3.4 (0.1-19) days. The main symptoms of the first attendance were fever (21/29), increased white blood cells (26/29), abdominal pain (16/29), and decreased or vanished fetal movements (7/29). Samples where listeria were identified were maternal blood (14 cases), excreta from birth canal (24 cases), placenta (one case), newborn blood (seven cases), newborn sputum (eight cases), newborn excreta from auditory meatus (three cases), cerebrospinal fluid (two cases) and ocular discharge (one case). Inflammation was detected in pathological examination of placenta in all subjects. Among them, three were diagnosed with mild chorioamnionitis; five with moderate chorioamnionitis; nine with moderate-to-severe chorioamnionitis and 12 with severe chorioamnionitis. Among 33 fetuses carried by 29 subjects, fetal outcomes include six miscarriages, nine stillbirths, four newborn deaths immediately after birth and four after treatment discontinuation, nine discharges after successful treatment in hospital, and one death after treatment. As for maternal outcomes, 29 pregnant women all recovered after delivery.
With the acute onset, high incidence of adverse pregnancy outcomes and low coverage of initial treatment, clinical physicians need to raise the awareness of listeriosis during pregnancy.
通过对 29 例妊娠合并李斯特菌感染患者的临床特征和结果进行回顾性研究，为李斯特菌病的诊断提供依据。
选择 2010 年 7 月至 2019 年 2 月期间在四川大学华西第二医院就诊的 29 例妊娠合并李斯特菌感染患者进行回顾性分析。分析患者的一般信息、临床症状、实验室结果和病原体检测等数据，总结其临床特征。
29 例患者的中位年龄为 28（18.0-42.0）岁。9 例在孕中期就诊，20 例在孕晚期就诊。就诊前中位病程为 3.4（0.1-19）天。初诊时主要症状为发热（21/29）、白细胞升高（26/29）、腹痛（16/29）和胎动减少或消失（7/29）。鉴定出李斯特菌的样本有：产妇血液（14 例）、生殖道分泌物（24 例）、胎盘（1 例）、新生儿血液（7 例）、新生儿痰液（8 例）、新生儿外耳道分泌物（3 例）、脑脊液（2 例）和眼分泌物（1 例）。所有患者的胎盘病理检查均有炎症。其中，3 例轻度绒毛膜羊膜炎；5 例中度绒毛膜羊膜炎；9 例中-重度绒毛膜羊膜炎，12 例重度绒毛膜羊膜炎。29 例患者携带的 33 例胎儿中，胎儿结局包括 6 例流产、9 例死胎、4 例新生儿出生后立即死亡和 4 例治疗中断后死亡、9 例在医院成功治疗后出院、1 例治疗后死亡。对于产妇结局，29 例孕妇均在分娩后康复。
妊娠合并李斯特菌感染起病急，不良妊娠结局发生率高，初始治疗覆盖率低，临床医生在妊娠期间需提高对李斯特菌病的认识。
