Spontaneous Listeria monocytogenes peritonitis: a population-based study of 13 cases collected in Spain.
OBJECTIVE
We aimed to assess the incidence, demographic data, clinical features, and outcome of peritoneal infections due to Listeria monocytogenes in individuals with cirrhosis.


METHODS
During a 10-yr study period, 153 cases of invasive listeriosis were recorded in a prospective population-based surveillance project carried out in Barcelona, Spain.


RESULTS
Thirteen cases were of spontaneous bacterial peritonitis by L. monocytogenes. Ages of the patients ranged between 29 and 85 yr. In addition to cirrhosis, underlying conditions included diabetes mellitus in four and malignancy in three. Bacteremia was present in six cases (46%). Only one patient with bacteremia developed meningitis. Analysis of the peritoneal fluid showed a mean (SD) protein content of 21.5 (9.6) g/L and leukocyte count of 7,273 (9,171) cells/ml. L. monocytogenes serotype 4b was the serogroup predominantly isolated (61%). The mortality rate was 30.7%. Eight patients received empirical antibiotic treatment with cephalosporins.


CONCLUSIONS
In geographical areas with a high incidence of listeriosis, L. monocytogenes should be suspected as a causative pathogen of spontaneous bacterial peritonitis in cirrhosis. Early adjustment of antibiotic therapy is essential to reduce mortality.
Nolla-Salas
Juan
J
Intensive Care Unit, Hospital del Mar, Barcelona, Spain.
Almela
Manuel
M
Gasser
Isabel
I
Latorre
Cristina
C
Salvadó
Margarita
M
Coll
Pere
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008089:Listeria monocytogenes; D008088:Listeriosis / Q000188:drug therapy; D008103:Liver Cirrhosis / Q000382:microbiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000453:epidemiology* / Q000382:microbiology*; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents