title: A cluster of Listeria monocytogenes infections in hospitalized adults.
abstract: BACKGROUND
  Listeriosis occurs mainly in persons at extremes of age and with immunocompromising conditions. It is believed that most cases of listeriosis are acquired in the community. A cluster of listeriosis in hospitalized patients prompted the present investigation.
  
  
  METHODS
  We conducted a case series study of listeriosis from August 21, 2006, to June 1, 2007, in a hospital in the city of Rio de Janeiro, Brazil.
  
  
  RESULTS
  Six patients with Listeria monocytogenes infection were identified: 5 during hospitalization and 1 at a day clinic. By the time the infection was diagnosed, 5 patients had been in the hospital for a mean of 9 days. All patients were elderly (median age, 80 years) and had immunocompromising conditions. Five (83%) patients died. Four patients developed bloodstream infections, 3 caused by serotype 1/2b. Two patients had peritonitis: one caused by serotype 3b and another by serotype 1/2b. Four L monocytogenes isolates belonged to a single pulse-field gel electrophoresis genotype, suggesting a common source. An epidemiologic investigation pointed to the hospital kitchen as the possible contamination.
  
  
  CONCLUSIONS
  Data suggest a health care-associated outbreak of listeriosis and highlight the importance of developing guidelines for prevention and treatment of health care-associated foodborne diseases, especially in hospitals with immunocompromised adult patients.
authors.affiliation: Faculdade de Medicina, Universidade Federal Fluminense, Niterói, Brazil. ianicksm@yahoo.com.br
authors.forename: Ianick Souto
authors.initials: IS
authors.lastname: Martins
authors.forename: Flavia Cristina da Conceição
authors.initials: FC
authors.lastname: Faria
authors.forename: Marco Antônio Lemos
authors.initials: MA
authors.lastname: Miguel
authors.forename: Manuela Pereira de Sá Colaço
authors.initials: MP
authors.lastname: Dias
authors.forename: Fernando Luís Lopes
authors.initials: FL
authors.lastname: Cardoso
authors.forename: Ana Cristina de Gouveia
authors.initials: AC
authors.lastname: Magalhães
authors.forename: Luiz Affonso
authors.initials: LA
authors.lastname: Mascarenhas
authors.forename: Simone Aranha
authors.initials: SA
authors.lastname: Nouér
authors.forename: André Victor
authors.initials: AV
authors.lastname: Barbosa
authors.forename: Deyse Christina
authors.initials: DC
authors.lastname: Vallim
authors.forename: Ernesto
authors.initials: E
authors.lastname: Hofer
authors.forename: Renata Fernandes
authors.initials: RF
authors.lastname: Rabello
authors.forename: Renata Fernandes
authors.initials: RF
authors.lastname: Rebello
authors.forename: Lee W
authors.initials: LW
authors.lastname: Riley
authors.forename: Beatriz Meurer
authors.initials: BM
authors.lastname: Moreira
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D015373:Bacterial Typing Techniques; D001938:Brazil; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality; D016172:DNA Fingerprinting; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D016867:Immunocompromised Host; D008089:Listeria monocytogenes / Q000145:classification* / Q000302:isolation & purification*; D008088:Listeriosis / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010538:Peritonitis / Q000453:epidemiology / Q000382:microbiology; D012703:Serotyping