title: Listeriosis at a tertiary care hospital in beijing, china: high prevalence of nonclustered healthcare-associated cases among adult patients.
abstract: BACKGROUND
  Listeriosis is an emerging infectious disease associated with high mortality. There are few published reports from East Asia and developing countries. Our goal was to describe the clinical characteristics and outcomes of patients diagnosed with Listeria monocytogenes at a tertiary care hospital in Beijing, China.
  
  
  METHODS
  Peking Union Medical College Hospital (PUMCH), an 1800-bed hospital, consists of 2 campuses that house different medical departments. We retrospectively reviewed all culture-proven cases of listeriosis occurring at PUMCH between 1999 and 2011. Point estimates and 95% confidence intervals are presented.
  
  
  RESULTS
  There were 38 patients with listeriosis: 5 neonatal, 8 maternal, and 25 nonmaternal. The median age of the adult nonmaternal patients was 47 (range, 18-79) years with a female predominance (72%). Forty percent (n = 10) had an underlying rheumatic disease. Forty-four percent of cases (n = 11) were healthcare-associated infections occurring a median of 20 (range, 3-44) days after hospital admission. Only 2 of the 11 healthcare-associated cases clustered in space and time. One healthcare-associated case occurred in a patient receiving KHI-272 therapy, an oral, irreversible dual EGFR/HER2 inhibitor. The neonatal and maternal listeriosis cases were similar to those reported in the literature.
  
  
  CONCLUSIONS
  Nonclustered healthcare-associated cases of L. monocytogenes occurred at a large tertiary care hospital in Beijing, China. The source of these infections is unclear. Although rare, in the setting of immunosuppression, Listeria should be considered in the differential diagnosis of healthcare-associated infections, even in the absence of a point-source outbreak.
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
authors.forename: Huan-Ling
authors.initials: HL
authors.lastname: Wang
authors.forename: Khalil G
authors.initials: KG
authors.lastname: Ghanem
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.forename: Shuang
authors.initials: S
authors.lastname: Yang
authors.forename: Tai-Sheng
authors.initials: TS
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007231:Infant, Newborn; D008089:Listeria monocytogenes / Q000302:isolation & purification*; D008088:Listeriosis / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D055815:Young Adult