Clinical Study On Listeriosis: 16 Years′Experience At A Tertiary Care Hospital In Beijing, China

[Background]:To better understand the clinical characteristics and predisposing factors of listeriosis.[Methods]:Retrospectively, we reviewed all medical records of definite listeriosis between January 1999 and December 2014 who were treated at Peking Union Medical College Hospital. We defined a case of listeriosis when a patient manifested with symptoms comparable with listeriosis and Listeria monocytogenes was isolated from cultures of normally sterile body sites, or from a non-sterile site (uterus swab) and pathologic study of placenta revealed chorioamnionitis, or acute neonatal listeria sepsis. We define an underlying condition if a patient has been diagnosed of and/or has been treated for a concurrent underlying disease within 1 month of the onset of listeria sepsis.[Results]:(1) Of 69 cases of listeriosis during this 16-year period,68.1%、23.2% and 8.7% occurred among non-pregnant adults, pregnant women and neonates, respectively. The number of listeriosis increased significantly during the latter 8 years. (2) The average age of 16 maternal listeriosis was 30±3.9 years, Clinical manifestations included fever (93.8%), leukocytosis (78.6%), chorioamnionitis (77.8%), and gastrointestinal symptoms (37.5%), fetal movement decrease or stop (31.3%). Listeria monocytogenes were isolated from blood (6 cases), uterus swab (6 cases), blood and uterus swab (1 case), and neonates (3 cases). All maternal cases recovered well after the termination of pregnancy. There were 8 fetal losses,7 neonates were complicated with listeria sepsis and were treated successfully. (3) All neonatal listeriosis were born to mothers with symptomatic listeriosis, which were suggestive of an intrauterine infection, all had disseminated sepsis with or without central nervous system (CNS) involvement, however 5 neonates responded well to treatment and survived. (4) Non-pregnant adult listeriosis were manifested as sepsis, CNS infection or both.91.5% occurred among immunocompromised hosts with an underlying disease, most likely, of connective tissue diseases (CTD) or malignancy. Female patients were predominant, younger, and more likely to have a CTD. The majority received empiric antibiotic therapy with low rate of effective coverage of listeriosis. The mortality rate was 36.2%. (5) There were 21 cases (46.7%) healthcare-associated listeriosis among non-pregnant adults infection, which involved 7 inpatient wards, however, they were non-clustered in time and ward, with an unknown origin of the infection.[Conclusions]:Listeriosis is most likely underestimated in China, clinicians, especially those who provide medical care to immunocompromised hosts and pregnant women should keep a vigilance of listeria infection, and empiric antibiotic coverage of listeria should be considered when sepsis is suspected among susceptible subjects.