Trends in US Hospital Stays for Listeriosis in Infants

Abstract

A B S T R A C T BACKGROUND AND OBJECTIVES: Although listeriosis is rare in infants, it is commonfor young infants with suspected serious bacterial infection to be treated empirically with agents selected, in part, for their activity against Listeria monocytogenes. Our objectives were to describe the recent epidemiology of hospital discharges for listeriosis among infants in the United States and to precisely estimate the incidence of listeriosis according to infant age and meningitis status. METHODS:We generated national estimates for listeriosis discharges in each of the 6 years for which samples were available in the Kids' Inpatient Database during the period 1997-2012. We used random-effects models to pool descriptive information and population rates across study years. RESULTS:The cumulative number of US hospital discharges for listeriosis in infants was 344 (95% confidence interval [CI]: 290-397) over the 6 study years. The pooled annual incidence rate in infants (per 100 000 births) was 1.41 (95% CI: 1.01-1.80) after accounting for marked fluctuation in annual rates (range: 0.66-1.86; I 2 5 79.3%). Discharges for listeriosis without meningitis were particularly rare after the first week of life. Our models predicted only 2.7 (95% CI: 1.1-4.2) and 1.8 (95% CI: 0.0-3.6) such discharges per year in infants admitted at ages 7 to 28 days and 29 to 364 days, respectively. CONCLUSIONS:From the perspective of providing coverage against listeriosis, the routine practice of including ampicillin in the empirical treatment of febrile infants should be reevaluated for those older than 1 week without clinical evidence of meningitis.

Listeriosis in mainland China: A systematic review

“…Perinatal listeriosis mostly occurred before 37 weeks of gestation, and the adverse event rate was higher than in non-perinatal listeriosis (Pucci et al, 2018); thus, it is recommended that empirical antibiotics be used to treat perinatal infections, even when the maternal blood culture is negative (Charlier et al, 2017). However, Veesenmeyer and Edmondson, among others, do not recommend the use of ampicillin as empirical treatment for newborn infections after the first week of life because of the low morbidity of listeriosis and high level of antimicrobial resistance of Gram-negative bacteria (Veesenmeyer and Edmonson, 2016); therefore, it is important to diagnose and treat perinatal listeriosis early. As not all samples from listeriosis patients are positive (Mansbridge et al, 2017), contributing to a delay in diagnosis of listeriosis, it is advisable to culture multiple types of sample for listeriosis initially (Awofisayo-Okuyelu et al, 2016).…”

Incidence, outcomes, and resource use in children with Stevens‐Johnson syndrome and toxic epidermal necrolysis

“…There were statistically significant age-based variations in frequency of disease. Incidence increased with age to a peak incidence in the [11][12][13][14][15] year cohort (38.4 per 100,000, P < 0.001) and then decreased to 14.1 per 100,000 (P < 0.001) for those older than 15 years. This variation was seen in all disease diagnosis groups ( Table 2).…”

“…Given that KID includes poststratification sampling weights, yearly data sets can be used to generate national estimates of information for children and adolescents in the United States . For example, the 2012 KID sample contains information on 3.2 million (unweighted) discharges from 4179 US hospitals in 44 participating states, which corresponds to a national estimate of 6.7 million (weighted) discharges …”

“…11 For example, the 2012 KID sample contains information on 3.2 million (unweighted) discharges from 4179 US hospitals in 44 participating states, which corresponds to a national estimate of 6.7 million (weighted) discharges. 12 (TEN) and a LOS of longer than 3 days were included. 8 Incorporating LOS can improve retrospective identification of SJS/TEN cases.…”

Is Tradition Trumping Evidence in the Treatment of Young, Febrile Infants?

“…Numbers were similarly low for Enterococcus, with the exception of UTI (0.28%, NNT 5 363), although in most studies the definition of UTI did not require a positive urinalysis or used fairly low colony count thresholds, suggesting that some of the "UTIs" might reflect asymptomatic bacteruria or contamination. 9 Veesenmeyer et al 8 analyzed data from 6 separate years between 1997 and 2012 from the Kids' Inpatient Database (KID), enabling the investigators to estimate the incidence of listeriosis on a population level. Expressed per 100 000 births, there were an estimated 0.56, 0.53, and 0.18 discharges per year for infants age 0 to 7 days, 7 to 28 days, and 29 to 364 days, respectively.…”