Ann Lab Med.  2018 Mar;38(2):102-109. 10.3343/alm.2018.38.2.102.

Increasing Incidence of Listeriosis and Infection-associated Clinical Outcomes

• Choi MH
• Park YJ
• Kim M
• Seo YH
• Kim YA
• Choi JY
• Yong D
• Jeong SH
• Lee K

• KMID: 2403354
• DOI: http://doi.org/10.3343/alm.2018.38.2.102

Abstract

BACKGROUND
Listeriosis caused by Listeria monocytogenes has a high case-fatality rate (CFR) of approximately 20% to 30%. An increasing incidence of listeriosis has been reported in many countries recently. We investigated the annual incidence, clinical characteristics, and outcomes of listeriosis at three different hospitals in Korea and evaluated the effects of appropriate empiric antimicrobial treatments on patient outcomes.
METHODS
We retrospectively collected the data of all culture-positive cases of human listeriosis from three hospitals of different sizes in Korea during 2006-2016 and calculated the annual number of cases and incidence per 100,000 admissions.
RESULTS
A total of 58 patients with L. monocytogenes were included in this study. The incidence of listeriosis was significantly higher in 2013-2016 than in 2006-2012 (RR 3.1; 95% CI 1.79-5.36; P < 0.001), mainly because of an increase in patients over 60 years of age (RR 3.69; 95% CI 1.70-8.02; P < 0.001). Multivariate analysis showed that healthcare-associated infection (adjusted OR, 12.15; 95% CI, 2.56-86.01; P=0.004) and empirical treatment with first-line antimicrobial agents (adjusted OR, 0.08; 95% CI, 0.00-0.63; P=0.044) were associated with CFR.
CONCLUSIONS
Healthcare-associated infections caused by L. monocytogenes are associated with high CFR. Adequate initial empirical treatments could reduce CFR, suggesting that careful consideration of an empirical antimicrobial regimen is warranted for elderly or immunocompromised patients admitted to the hospital.

Keyword

Listeria monocytogenes; Listeriosis; Incidence; Outcome; Empirical treatment

MeSH Terms

Aged
Anti-Infective Agents
Humans
Immunocompromised Host
Incidence*
Korea
Listeria monocytogenes
Listeriosis*
Multivariate Analysis
Retrospective Studies
Anti-Infective Agents

Figure

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  Fig. 1 Increase in the number of Listeria monocytogenes isolates according to age distribution, 2006–2016.

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  Fig. 2 Trends in non-pregnancy-associated listeriosis categorized by (A) age distribution and (B) underlying disease, 2006–2012 vs 2013–2016.Abbreviations: Postop, postoperative states; HM, hematologic malignancies; DM, diabetes mellitus; CRD, chronic respiratory diseases; CLD, chronic liver diseases; CKD, chronic kidney diseases.

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