Neonatal listeriosis during a countrywide epidemic in South Africa: A tertiary hospital’s experience

Dramowski, Angela; Lloyd, Lizel G; Bekker, Adrie; Holgate, Sandi; Aucamp, Marina; Reddy, Kessendri; Finlayson, Heather

doi:10.7196/samj.2018.v108i10.13207

Cited by 8 publications

(4 citation statements)

References 28 publications

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“…Mortality rate in this study was 26%, similar to that observed in another tertiary hospital in South Africa during the similar outbreak. 9 Listeriosis is known to have an average case-fatality rate of 20%-30% despite adequate antimicrobial treatment. The frequency of abortion and stillbirth increases the overall mortality rate to >50%, 24 although this was not looked at in this study.…”

Section: Discussionmentioning

confidence: 99%

“…The infants are often born preterm, and the mean postnatal age at onset of symptoms for early-onset disease is 1.5 days. 8,9 Clinical presentations of neonatal listeriosis include septicemia (81%-88%), respiratory distress or pneumonia (38%), meningitis (24%) and more rarely myocarditis and granulomatosis infantisepticum. [10][11][12] Neonatal disease and outcomes are often more severe in contrast to mild maternal disease.…”

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confidence: 99%

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

Ntuli

Wadula

Nakwa

et al. 2021

Pediatric Infectious Disease Journal

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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.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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

Ntuli

Wadula

Nakwa

et al. 2021

Pediatric Infectious Disease Journal

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“…Interestingly, the first reported case of listeriosis was an isolation of LMO from the cerebrospinal fluid (CSF) of a four-year-old immunocompromised child in Africa by Benallegue et al (1968) . Subsequently, cases of neonatal listeriosis have been reported in Algeria ( Ramdani-Bouguessa and Rahal, 2000 ), Tunisia ( Fendri et al, 1989 ) and South Africa ( Dramowski et al, 2018 ). Researchers have conducted several studies in African countries following numerous reported infections with strong clinical symptoms.…”

Section: Characteristics and Distribution Of Listeriamentioning

confidence: 99%

A review of the literature of Listeria monocytogenes in Africa highlights breast milk as an overlooked human source

Sarr,

Alou,

Padane

et al. 2023

Front. Microbiol.

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According to the latest WHO estimates (2015) of the global burden of foodborne diseases, Listeria monocytogenes is responsible for one of the most serious foodborne infections and commonly results in severe clinical outcomes. The 2013 French MONALISA prospective cohort identified that women born in Africa has a 3-fold increase in the risk of maternal neonatal listeriosis. One of the largest L. monocytogenes outbreaks occurred in South Africa in 2017–2018 with over 1,000 cases. Moreover, recent findings identified L. monocytogenes in human breast milk in Mali and Senegal with its relative abundance positively correlated with severe acute malnutrition. These observations suggest that the carriage of L. monocytogenes in Africa should be further explored, starting with the existing literature. For that purpose, we searched the peer-reviewed and grey literature published dating back to 1926 to date using six databases. Ultimately, 225 articles were included in this review. We highlighted that L. monocytogenes is detected in various sample types including environmental samples, food samples as well as animal and human samples. These studies were mostly conducted in five east African countries, four west African countries, four north African countries, and two Southern African countries. Moreover, only ≈ 0.2% of the Listeria monocytogenes genomes available on NCBI were obtained from African samples, contracted with its detection. The pangenome resulting from the African Listeria monocytogenes samples revealed three clusters including two from South-African strains as well as one consisting of the strains isolated from breast milk in Mali and Senegal and, a vaginal post-miscarriage sample. This suggests there was a clonal complex circulating in Mali and Senegal. As this clone has not been associated to infections, further studies should be conducted to confirm its circulation in the region and explore its association with foodborne infections. Moreover, it is apparent that more resources should be allocated to the detection of L. monocytogenes as only 15/54 countries have reported its detection in the literature. It seems paramount to map the presence and carriage of L. monocytogenes in all African countries to prevent listeriosis outbreaks and the related miscarriages and confirm its association with severe acute malnutrition.

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“…Despite considering L. monocytogenes as a part of the faecal microbiota in most mammals, up to 5% of healthy animals should be taken into consideration as the asymptomatic carriers [16]. It seems that the study on human (as the permanent reservoir of L. monocytogenes) microbiota samples including intestines, vagina, milk, and urine have not taken into consideration as well as human-to-human transmission routs [16][17][18]. Given the importance of L. monocytogenes infection connected to pregnant women and its consequences in pregnancy, this study, based on the type of samples, used the vaginal swabs to detect L. monocytogenes infections.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Listeria monocytogenes infection in women with spontaneous abortion, normal delivery, fertile and infertile

Ahmadi

Ramazanzadeh

Derakhshan

et al. 2022

BMC Pregnancy Childbirth

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Background Listeria monocytogenes with a vast range of natural reservoirs is more known for being a food-borne pathogen. Human infections have shown an impact on pregnancy outcomes, so, this study surveyed the frequency of L. monocytogenes infection involving different groups of women. Methods This study enrolled a total sample consisting of 109 women with spontaneous abortion, 109 women with normal delivery, 100 fertile women, and 99 infertile women aged 19–40 years and willing to participate in the study. The research tool in this study was a questionnaire and Polymerase chain reaction (PCR) test. Results According to the results, the frequency of L. monocytogenes infection was 4/109 (3.66%) observed among women with spontaneous abortion, 2/109 (1.83%) among women with normal delivery, 3/100 (3%) among fertile women, and 0/99 (0%) among infertile women. Conclusion There was no significant relationship between Listeria monocytogenes infection and pregnancy outcomes of spontaneous abortion and infertility.

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Neonatal listeriosis during a countrywide epidemic in South Africa: A tertiary hospital’s experience

Abstract: This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Cited by 8 publications

References 28 publications

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

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

A review of the literature of Listeria monocytogenes in Africa highlights breast milk as an overlooked human source

Prevalence of Listeria monocytogenes infection in women with spontaneous abortion, normal delivery, fertile and infertile

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