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KMID : 0984720030350010037
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Infection and Chemotherapy
2003 Volume.35 No. 1 p.37 ~ p.44
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Listeria monocytogenes Infections of Adult Patients at a Tertiary-care Hospital in Korea
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Kang Su-Gyoung
Shin Hee-Bong
Kim Mi-Na
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Abstract
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Background: Listeria monocytogenes is a foodborne oppotunistic pathogen causing meningoencephalitis and bacteremia in certain groups such as neonates, pregnant women, the elderly, or immunosuppressed patients. We investig ated the predisposing conditions, and laboratory and clinical features for listeriosis of non-pregnant adult patients in tertiary care hospitals.
Methods: Sixteen patients diagnosed at AMC from 1997 to April 2002 were newly analyzed. In addition, 20 cases published in domestic literatures from 1973 to 1997 were retrospectively reviewed for their medical records or literatures to evaluate demographic, clinical, and laboratory data.
Results: While AMC cases comprised 14 bacteremia, 2 meningitis, and 1 peritonitis, literature cases comprised 17 meningitis, 2 bacteremia, and 1 endocarditis. All but one endocarditis patients were in immunocompromised states such as malignancy (19 patients), diabetes (7), transplantation (5), SLE, asthma with steroid therapy (4), elderly alcoholics (1), and elderly tuberculosis (1). Ten of 36 cases developed fever 5 days after admission. All but two strains were susceptible to penicillin or ampicillin, and 28 of 29 treated cases received β-lactam agents. Fifteen patients (41.6%), including 11 patients with malignancy, expired. Blood cultures were positive in all 19 meningitis cases, but direct smears of CSF for bacteria were positive in only 20%.
Conclusion: L. monocytogenes frequently caused life-threatening sepsis or meningitis in immunocompromised patients at a tertiary care hospitaL. For early diagnosis of L. monocytogenesis infection, microbiology laboratories are advised to improve the sensitivity of CSF smear.
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KEYWORD
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listeria monocytogenes, tertiary care hospital, sepsis, meningitis, immunocompromised patients
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