Listeriosis: An emerging public health problem especially among the elderly.
OBJECTIVE
To analyze the incidence trend of listeriosis, its present epidemiology and the potential benefit of aminoglycosides during the last two decades.


METHODS
We reviewed all cases of invasive listeriosis detected during a 22-year period in a large tertiary hospital. Two equal periods of 11 years were compared.


RESULTS
We detected 111 cases of listeriosis (32 during the first 11-year period and 79 during the second). Incidence of listeriosis increased significantly (from 4.66/10(6) inhabitants to 10.39/10(6) inhabitants; P = .001). In the second period, there were more patients >65 years (21.9%-45.6%; P = .02) and with no significant underlying diseases (0 vs. 16.5%; P = .02). Comparing clinical presentations between the two periods, primary bacteremia increased (40.6% vs. 55.7%), while central nervous system infections decreased (34.4% vs. 27.8%). Cotrimoxazole (SXT) use increased significantly in the second period (from 6.3% to 40.5%, P = .001) while the administration of aminoglycosides decreased (from 40.6% to 21.5%, P = .04). The use of combination therapy did not have any impact on mortality, however it did increase toxicity.


CONCLUSIONS
Listeriosis should be considered an emerging health problem, especially among the elderly, including those with no underlying medical conditions. The use of aminoglycosides does not seem to be justified according to our data.
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo 46, 28007 Madrid, Spain. pmunoz@micro.hggm.es
Patricia
P
Muñoz
Loreto
L
Rojas
Eleonora
E
Bunsow
Elena
E
Saez
Laura
L
Sánchez-Cambronero
Luis
L
Alcalá
Marta
M
Rodríguez-Creixems
Emilio
E
Bouza
D000328:Adult; D000367:Age Factors; D000368:Aged; D000617:Aminoglycosides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D021821:Communicable Diseases, Emerging / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008088:Listeriosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents