Perinatal listeriosis patients treated at a maternity hospital in Beijing, China, from 2013-2018

Abstract

Background: Listeriosis is a rare but severe foodborne infectious disease. Perinatal listeriosis is often associated with septicemia, central nervous system (CNS) infection, and serious adverse pregnancy outcomes (miscarriage and neonate death). Here we report the characteristics and outcomes of perinatal listeriosis cases treated over 6 years at Beijing Obstetrics and Gynecology Hospital (BOGH), the largest maternity hospital in China. Methods: We retrospectively reviewed the records of laboratory-confirmed, pregnancy-associated listeriosis cases treated from January 1, 2013 to December 31, 2018. The clinical manifestations, laboratory results, perinatal complications and outcomes (post-natal follow-up of 6 months) were investigated. Results: In BOGH, 12 perinatal listeriosis cases were diagnosed based on Listeria monocytogenes positive culture, including 10 single pregnancies and 2 twin pregnancies. The corresponding incidence of pregnancy-associated listeriosis was 13.7/100,000 deliveries. Among those cases, four pregnant women and four newborns had septicemia, and two of the neonates with septicemia also suffered CNS infection. All the maternal patients recovered. Two inevitable miscarriages and four fetal stillbirths occurred. Of the eight delivered newborns, six survived, and two died within 2 days from birth. None of the survivors had neurological sequelae during a 6-month follow-up. The overall feto-neonatal fatality rate was 57.1%; notably, this rate was 100% for infections occurring during the second trimester of pregnancy and only 14.3% for those occurring in the third trimester. Conclusions: Perinatal listeriosis is associated with high feto-neonatal mortality, and thus, a public health concern. Additional large-scale studies are needed to strengthen the epidemiological understanding of listeriosis in China.

Retrospective analysis of pregnancy-associated listeriosis in a city in southeastern China (Xiamen) from 2015 to 2023

“…Infections contracted during the rst trimester present the gravest outcomes, with a mortality rate of 100%, whereas third-trimester infections show a reduced mortality rate of 57.1%. Nevertheless, the prognosis for pregnant women remains positive, in line with other research ndings [3,10,12,14] .…”

“…Notably, the prevalence of LM infection exhibits signi cant variation globally, with higher incidence rates observed in certain developing regions and an uptrend in developed nations [7] . As a major city in the southeast of China (Xiamen), the incidence of pregnancy-associated listeriosis is 7.15/100,000 deliveries, between Xi'an (a city in the northwest) and Beijing (a city in the north) in China [3,8] , but higher than some European countries [7,9,10] . Pregnancy-associated listeriosis is sporadic, mainly concentrated in spring and summer, consistent with previous studies [8,11] .…”

“…If LM is found in blood culture, it is considered that the patient has sepsis. If LM is found in cerebrospinal uid culture, it is considered that the patient has a central nervous system infection [3] . Collect demographic information, clinical manifestations, laboratory tests, complications, and outcomes from patient electronic medical records for statistical analysis.…”

“…The term "stillbirth" refers to fetal death that occurs between 24 and 41 weeks of pregnancy, while fetal loss before 24 weeks is referred to as inevitable miscarriage [3] . Furthermore, we calculated the overall feto-neonatal mortality rate of pregnancy-associated listeriosis, which includes miscarriage, stillbirth, and newborn deaths.…”

“…Pregnant women are particularly susceptible to LM infection, with incidence rates 12-20 times higher than those of the general population Pregnant women infected with LM often exhibit u-like symptoms, such as fever, headache, diarrhea, muscle pain, or other digestive-related symptoms [1,2] . However, the consequences can be severe, leading to premature birth, miscarriage, sepsis, central nervous system (CNS) involvement, and even death, with a mortality rate of up to 57.1% [3] . In Europe, of LM infection ranges from 0.1 to 11.3 per million people, and about 20% of cases involve perinatal pregnant women or newborns [4] .…”