Infections by Listeria monocytogenes.
Rev Chilena Infectol. 2013 Aug;30(4):417-25.
[Article in Spanish]
Sedano R1, Fica A, Guiñez D, Braun S, Porte L, Dabanch J, Weitzel T, Soto A.
1Departamento de Medicina, Hospital Militar de Santiago, Santiago, Chile.
Listeria monocytogenes infections have been poorly characterized in Chile.
To evaluate clinical manifestations and risk factors associated to a fatal outcome in a series of patients.
retrospective analysis of cases from 1991 to 2012.
Twenty three cases were identified, including 2 diagnosed after prolonged hospitalization (8.7%) with an average age of 68.4 years (range 44-90). Known predisposing factors were age > 65 years (60.9%), diabetes mellitus (40.9%), and immunosuppression (27.3%). Most cases presented after 2003 (70%). No cases associated with neonates, pregnancy or HIV infections were recorded. Patients presented with central nervous system (CNS) infection (39%), including 8 cases of meningitis and one of rhomboencephalitis; bacteremia (43.5%), including one case with endocarditis; abscesses (8.7%); and other infections (spontaneous bacterial peritonitis and pneumonia; 8.7%). Risky food consumption was found in 80% of those asked about it. Predominant clinical manifestations were fever (90.9%), and confusion (63.6%). CNS infections were associated to headache (OR 21, p < 0.05), nausea and vomiting (OR 50, p < 0.01). Only 45.5% received initial appropriate empirical therapy and 36.4% a synergistic combination. Eight patients died (34.8%), this outcome was associated to bacteremia (OR 8.25; IC95 1.2-59 p < 0.05).
monocytogenes infections appear to be increasing in Chile, causing infections in different sites, attacking vulnerable patients, and have a high case-fatality ratio, especially among those with bacteremia.
Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, F.O.D, Infecciones cardio-vasculares, Infecciones del SNC, Infecciones intraabdominales, Infecciones respiratorias, Infecciones y Alimentos, Sepsis.