title: Predictive risk factors for Listeria monocytogenes meningitis compared to pneumococcal meningitis: a multicenter case-control study.
abstract: OBJECTIVE
  Various immunocompromised conditions increase the risk of meningitis caused by Listeria monocytogenes. However, the relative importance of these risk factors has not been well established. We determined the risk factors that predict meningitis due to L. monocytogenes compared to that caused by Streptococcus pneumoniae.
  
  
  METHODS
  A nationwide multicenter case-control study was conducted in Korea. Cases of meningitis caused by L. monocytogenes between 1998 and 2013 were included. Patients with pneumococcal meningitis were included as controls. Multivariate logistic regression analysis was used to predict the risk factors of Listeria meningitis.
  
  
  RESULTS
  A total of 36 cases and 113 controls were enrolled. The most significant predictive risk factor of Listeria meningitis was a prior history of receiving immunosuppressive therapy (odds ratio 8.12, 95 % CI 2.47-26.69). Chronic liver disease was the second most important predictive risk factor (OR 5.03, 95 % CI 1.56-16.22). Delaying appropriate antibiotic therapy by more than 6 h (hazard ratio 2.78) and fatal underlying disease (hazard ratio 2.88) were associated with increased mortality.
  
  
  CONCLUSIONS
  Patients with a prior history of receiving immunosuppressive therapy within 1 month and chronic liver disease have 8.1-fold and 5-fold increased risk of meningitis by L. monocytogenes compared to S. pneumoniae, respectively.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.|Department of Internal Medicine, Dongnam Institution of Radiological and Medical Sciences, Busan, Korea.
authors.forename: Seungjin
authors.initials: S
authors.lastname: Lim
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea. iddrchung@gmail.com.
authors.forename: Doo Ryeon
authors.identifier: http://orcid.org/0000-0001-9267-101X
authors.initials: DR
authors.lastname: Chung
authors.affiliation: Division of Infectious Diseases, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Yeon-Sook
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Division of Infectious Diseases, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Kyung Mok
authors.initials: KM
authors.lastname: Sohn
authors.affiliation: Division of Infectious Diseases, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Seung-Ji
authors.initials: SJ
authors.lastname: Kang
authors.affiliation: Division of Infectious Diseases, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Sook-In
authors.initials: SI
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Shin-Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Hyun Ha
authors.initials: HH
authors.lastname: Chang
authors.affiliation: Division of Infectious Diseases, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Seung Soon
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: In-Gyu
authors.initials: IG
authors.lastname: Bae
authors.affiliation: Division of Infectious Diseases, Inje University Busan Paik Hospital, Busan, Korea.
authors.forename: Chisook
authors.initials: C
authors.lastname: Moon
authors.affiliation: Division of Infectious Diseases, Dankook University Hospital, Cheonan, Korea.
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Rhee
authors.affiliation: Division of Infectious Diseases, Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Jin Seo
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Konkuk University Hospital, Seoul, Korea.
authors.forename: Hyun Kyun
authors.initials: HK
authors.lastname: Ki
authors.affiliation: Division of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Hyun Ah
authors.initials: HA
authors.lastname: Kim
authors.affiliation: Division of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Seong Yeol
authors.initials: SY
authors.lastname: Ryu
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Joon-Sup
authors.initials: JS
authors.lastname: Yeom
authors.affiliation: Division of Infectious Diseases, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: Jun Seong
authors.initials: JS
authors.lastname: Son
authors.affiliation: Division of Infectious Diseases, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: Soo-Youn
authors.initials: SY
authors.lastname: Moon
authors.affiliation: Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kwon
authors.affiliation: Division of Infectious Diseases, Dong-A University Hospital, Busan, Korea.
authors.forename: Hyuck
authors.initials: H
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Sang Taek
authors.initials: ST
authors.lastname: Heo
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
authors.forename: Cheol-In
authors.initials: CI
authors.lastname: Kang
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008089:Listeria monocytogenes; D008297:Male; D008584:Meningitis, Listeria / Q000453:epidemiology*; D008586:Meningitis, Pneumococcal / Q000453:epidemiology*; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Elderly; Immunocompromised host; Listeriosis; Liver diseases; Streptococcus pneumoniae