title: Listeria monocytogenes-associated biliary tract infections: a study of 12 consecutive cases and review.
abstract: At present, little is known regarding Listeria monocytogenes-associated biliary tract infection, a rare form of listeriosis.In this article, we will study 12 culture-proven cases reported to the French National Reference Center for Listeria from 1996 to 2013 and review the 8 previously published cases.Twenty cases were studied: 17 cholecystitis, 2 cholangitis, and 1 biliary cyst infection. Half were men with a median age of 69 years (32-85). Comorbidities were present in 80%, including cirrhosis, rheumatoid arthritis, and diabetes. Five patients received immunosuppressive therapy, including corticosteroids and anti-tumor necrosis factor biotherapies. Half were afebrile. Blood cultures were positive in 60% (3/5). Gallbladder histological lesions were analyzed in 3 patients and evidenced acute, chronic, or necrotic exacerbation of chronic infection. Genoserogroup of the 12 available strains were IVb (n=6), IIb (n=5), and IIa (n=1). Their survival in the bile was not enhanced when compared with isolates from other listeriosis cases. Adverse outcome was reported in 33% (5/15): 3 deaths, 1 recurrence; 75% of the patients with adverse outcome received inadequate antimicrobial therapy (P=0.033).Biliary tract listeriosis is a severe infection associated with high mortality in patients not treated with appropriate therapy. This study provides medical relevance to in vitro and animal studies that had shown Listeria monocytogenes ability to survive in bile and induce overt biliary infections.
authors.affiliation: Institut Pasteur, Biology of Infection Unit (CC, CF, LT, ML); Institut Pasteur French National Reference Center and WHO Collaborating Center for Listeria (CC, BC, HBD, AL, ML); Inserm U1117 (CC, CF, LT, ML); Université Paris Descartes, Sorbonne Paris Cité, Centre d'Infectiologie Necker-Pasteur, Hôpital Necker-Enfants Malades, Institut Imagine (CC, ML); Service de Chirurgie viscérale, Centre Hospitalier Universitaire de Nantes (JP); Service de Chirurgie viscérale et digestive, Centre Hospitalier de Roubaix (DA, LG); Service d'Anatomopathologie et Cytologie, Centre Hospitalier Universitaire de Nantes (CB); Service d'Anatomopathologie et Cytologie, Centre Hospitalier de Roubaix (FC); and Service d'Anatomopathologie et Cytologie, Centre Hospitalier de Pau (VC).
authors.forename: Caroline
authors.initials: C
authors.lastname: Charlier
authors.forename: Cindy
authors.initials: C
authors.lastname: Fevre
authors.forename: Laetitia
authors.initials: L
authors.lastname: Travier
authors.forename: Benoît
authors.initials: B
authors.lastname: Cazenave
authors.forename: Hélène
authors.initials: H
authors.lastname: Bracq-Dieye
authors.forename: Juliette
authors.initials: J
authors.lastname: Podevin
authors.forename: Daher
authors.initials: D
authors.lastname: Assomany
authors.forename: Lydie
authors.initials: L
authors.lastname: Guilbert
authors.forename: Céline
authors.initials: C
authors.lastname: Bossard
authors.forename: Françoise
authors.initials: F
authors.lastname: Carpentier
authors.forename: Valérie
authors.initials: V
authors.lastname: Cales
authors.forename: Alexandre
authors.initials: A
authors.lastname: Leclercq
authors.forename: Marc
authors.initials: M
authors.lastname: Lecuit
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000382:microbiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D001660:Biliary Tract Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002761:Cholangitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002763:Cholecystectomy / Q000706:statistics & numerical data; D002764:Cholecystitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D041761:Cholecystolithiasis / Q000453:epidemiology; D015897:Comorbidity; D003560:Cysts / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000382:microbiology; D005602:France / Q000453:epidemiology; D005705:Gallbladder Diseases / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008089:Listeria monocytogenes / Q000235:genetics; D008088:Listeriosis / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008508:Medication Errors; D008875:Middle Aged; D009336:Necrosis; D010406:Penicillins / Q000627:therapeutic use; D011159:Population Surveillance; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D010406:Penicillins