Characteristics and Outcomes of Neonates With Blood Stream Infection Due to Listeria monocytogenes

Abstract

Background: Infection due to Listeria monocytogenes (LM) is rare in neonates; thus, its clinical presentation and outcomes are not commonly reported, especially in low-and middle-income countries. In 2017, South Africa had an outbreak due to LM. Objective: To determine demographic characteristics, clinical and laboratory findings and outcomes of all neonates infected with LM during the outbreak period. Methods: This is a retrospective analytic study. Clinical and laboratory records of neonates admitted at Chris Hani Baragwanath Academic Hospital from January 2017 to May 2018 with positive blood and cerebrospinal fluid culture with LM were reviewed for demographic characteristics, clinical presentation, ancillary laboratory test results and outcomes at hospital discharge. Results: There were 42 neonates with positive cultures due to LM. Thirtyfour (81%) were born preterm. Mode of delivery was vaginal in 78.6% and 31.0% were HIV exposed. All patients presented within the first 6 days of life as an early-onset disease. Common clinical presentation was respiratory depression (52.4%) and respiratory distress (38.1%) with 69% requiring invasive or noninvasive respiratory support. Common abnormal laboratory findings were high C-reactive protein (77.1%) followed by leukopenia (23.8%). Fourteen patients (40%) had features of meningitis based on blood and cerebrospinal fluid findings (4 culture proven). There were 11 deaths at hospital discharge, giving a mortality rate of 26.2%. Conclusions:The majority of neonates infected with LM were born preterm, raising the possibility that LM itself may have been responsible for preterm labor. All presented in the first 6 days of life and most presented with respiratory distress or depression. A high proportion had meningitis, and there was a high-mortality overall.

Clinical and Laboratory Characteristics of Patients infected by Listeria monocytogenes at a Tertiary Hospital in Hefei City, China

“…Pneumonia was very common and was observed in eleven cases (45.8%) in our study. A study in South Africa showed that 33.3% of neonates were diagnosed with congenital pneumonia, 24 but this value was lower than the 66.7% found in our study. Similarly, in the past 40 years, only 16 pneumonia cases have been reported in France, either as isolated case reports or as small groups of two to seven cases.…”

Clinical characteristics and prognosis of pediatric Listeria monocytogenes meningitis based on 10-year data from a large children’s hospital in China

“…Early-onset neonatal LM meningitis was defined as age at onset within 7 days; whereas, late-onset LM meningitis referred to age at onset between 7 and 28 days ( 21 ). The LM meningitis hospitalization mortality rate was defined as the number of patients who died during hospitalization divided by the total number of patients.…”

Evidence of Virulent Multi-Drug Resistant and Biofilm-Forming Listeria Species Isolated from Various Sources in South Africa

“…Furthermore, pregnant women are reporting symptoms such as headaches, chills, dizziness, and gastroenteritis, which can lead to stillbirth, early delivery, abortion, or septicemia in the child [7]. In addition, listeriosis may lead to other fatal conditions, such as encephalitis and rhombencephalitis, and these may result to meningoencephalitis, conjunctivitis, pneumonia, and meningitis, especially in infants [8][9][10].…”