Vázquez Elena, de Gregorio Oscar, Álvarez Carmen, Soriano Vicente, Corral Octavio, Ortega-de la Puente Alfonso, de la Cruz-Echeandía Marina, Blanco-Valencia Xiomara Patricia, Royuela Ana, Martín-Portugués Mario, Esteban-Sampedro Jorge, Moreno-Torres Víctor
UNIR Health Sciences School and Medical Center, Madrid, Spain.
Escuela Superior de Ingeniería y Tecnología, UNIR, Madrid, Spain.
Pathog Glob Health. 2025 Jul-Sep;119(5-6):151-157. doi: 10.1080/20477724.2025.2472300. Epub 2025 Feb 27.
Immunosuppression (IS) determines a higher risk of disease severity from LM) infection.
We examined the epidemiology of IS in all patients hospitalized with LM in Spain from 2000 to 2021 in the National Registry of Hospital Discharges. IS was defined by liver disease (LD), diabetes mellitus (DM), chronic kidney disease (CKD), solid organ transplantation (SOT), bone marrow transplantation (BMT), primary immunodeficiencies (ID), systemic autoimmune diseases (SAD), solid organ neoplasms (SON), and hematological neoplasms (HN).
Among 8,152 admissions with LM, 48% were IS. There was an increase from 39.5% to 60% during the study period, mainly driven by rises in DM (from 12.6% to 26.2%), SON (from 9.9% to 17.5%), CKD (from 4.4% to 16.3%), HN (from 6.6% to 13.4%), and LD (from 4.9% to 6.6%) ( < 0.001 for all trends). IS fatality rate was higher than in non-IS (22.4% vs 11.3%; OR = 2.09). The proportion of LM patients with IS among LM in-hospital deaths increased from 57.1% in 2000 to 67.95% in 2021 ( < 0.001). Fatality risk differed according to baseline IS condition: LD (OR = 2.42), CKD (OR = 1.49), SON (OR 3.01) and HN (OR 1.45).
The prevalence of IS among patients hospitalized with LM in Spain has risen over the past two decades, with a growing impact on fatality rates. These findings should prompt further efforts to prevent and manage properly LM infection.
免疫抑制（IS）决定了因感染产单核细胞李斯特菌（LM）而导致疾病严重程度更高的风险。
我们在国家医院出院登记处研究了2000年至2021年期间西班牙所有因LM住院患者的IS流行病学情况。IS的定义包括肝病（LD）、糖尿病（DM）、慢性肾病（CKD）、实体器官移植（SOT）、骨髓移植（BMT）、原发性免疫缺陷（ID）、系统性自身免疫性疾病（SAD）、实体器官肿瘤（SON）和血液系统肿瘤（HN）。
在8152例因LM入院的患者中，48%存在IS。在研究期间，这一比例从39.5%上升至60%，主要是由DM（从12.6%升至26.2%）、SON（从9.9%升至17.5%）、CKD（从4.4%升至16.3%）、HN（从6.6%升至13.4%）和LD（从4.9%升至6.6%）的增加所推动（所有趋势的P均<0.001）。IS患者的死亡率高于非IS患者（22.4%对11.3%；OR = 2.09）。在医院内死亡的LM患者中，IS患者的比例从2000年的57.1%增至2021年的67.95%（P<0.001）。根据基线IS状况，死亡风险有所不同：LD（OR = 2.42）、CKD（OR = 1.49）、SON（OR 3.01）和HN（OR 1.45）。
在过去二十年中，西班牙因LM住院患者中IS的患病率有所上升，对死亡率的影响日益增大。这些发现应促使人们进一步努力预防和妥善管理LM感染。
