Comorbidities and factors associated with central nervous system infections and death in non-perinatal listeriosis: a clinical case series.
Listeriosis is a rare disease caused by the bacterium Listeria monocytogenes and mainly affects at risk people. Listeriosis can lead to sepsis, central nervous system (CNS) infections and death. The objectives of this study were to describe and quantify comorbidities and neurological sequelae underlying non-perinatal listeriosis cases and to describe the factors associated with death and CNS infections in non-perinatal listeriosis.



We retrospectively collected clinical data through computerized, paper or microfilmed medical records in two Belgian university hospitals. Logistic regression models and likelihood ratio tests allowed identifying factors associated with death and CNS infections.



Sixty-four cases of non-perinatal listeriosis were included in the clinical case series and 84 % were affected by at least one comorbid condition. The main comorbidities were cancer, renal and severe cardio-vascular diseases. Twenty-nine patients (45 %) suffered from a CNS infection and 14 patients (22 %) died during hospitalization, among whom six (43 %) had a CNS involvement. Among surviving patients, eleven suffered from neurological sequelae (22 %) at hospital discharge; all had CNS infection. Five of these patients (45 %) still suffered of their neurological sequelae after a median follow-up of one year (range: 0.08-19). The factor associated with death during the hospitalization was the presence of a severe cardiovascular disease (OR = 4.72, p = 0.015). Two factors inversely related with CNS infections were antibiotic monotherapy (OR = 0.28, p = 0.04) and the presence of renal disease (OR = 0.18, p = 0.02).



In a public health context these results could be a starting point for future burden of listeriosis studies taking into account comorbidity.
Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte B1.30.15, Brussels, 1200, Belgium. charline.maertens@uclouvain.be.
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Maertens De Noordhout
Ghent University, Merelbeke, Belgium.|University of Florida, Gainesville, Florida, USA.
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Devleesschauwer
University Department of Neurology, CHR Citadelle, Liège, Belgium.
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Maertens De Noordhout
Department of Neurology, University Medical Center, Göttingen, Germany.
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Blocher
Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
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Haagsma
University of Florida, Gainesville, Florida, USA.|Utrecht University, Utrecht, The Netherlands.
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Havelaar
Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte B1.30.15, Brussels, 1200, Belgium.
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Speybroeck
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D002494:Central Nervous System Infections / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008089:Listeria monocytogenes; D008088:Listeriosis / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult
Central nervous system infections; Clinical series; Comorbidities; Death; Listeriosis