Listeria monocytogenes-associated endovascular infections: A study of 71 consecutive cases.
Aged
Aged, 80 and over
Aneurysm
/ microbiology
Endocarditis, Bacterial
/ epidemiology
Epidemiological Monitoring
Female
France
/ epidemiology
Heart Valve Prosthesis
/ microbiology
Hospital Mortality
Humans
Listeria monocytogenes
/ pathogenicity
Listeriosis
/ epidemiology
Male
Middle Aged
Retrospective Studies
Risk Factors
Aneurysm
Endocarditis
Listeria monocytogenes
Listeriosis
Prosthesis
Journal
The Journal of infection
ISSN: 1532-2742
Titre abrégé: J Infect
Pays: England
ID NLM: 7908424
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
20
02
2019
revised:
19
06
2019
accepted:
26
07
2019
pubmed:
4
8
2019
medline:
25
7
2020
entrez:
4
8
2019
Statut:
ppublish
Résumé
Listeria monocytogenes-associated endovascular infections are not well characterized. Retrospective study of 71 culture-proven cases reported to the French National Reference Center for Listeria from 1993 to 2018. Seventy-one cases were identified: 42 with vascular aneurysms/prosthetic infections, 27 with endocarditis, 2 with both. Fifty-eight were men (82%); median age was 75 years [46-92]; 93% reported co-morbidities (66/71), including 50% with immunosuppressive conditions. Vascular infections consisted of infected aneurysms (68%) or prosthetic graft infections (32%); vascular rupture was reported in 25/42 (60%). Tissue samples grew L. monocytogenes in 98% (43/44) and blood cultures in 64% (27/42). Endocarditis cases involved prosthetic or native valves or intracardiac devices in respectively 62% (18/29), 28% (8/29) and 10% (3/29). Infected valves were aortic (62%, 16/26), mitral (31%, 8/26) or both (8%, 2/26); 38% patients required surgery; 45% displayed heart failure; 17% had concomitant neurolisteriosis. In-hospital mortality in vascular infections was 12% (5/42) and 41% (12/29) for Lm-associated endocarditis. Endovascular listeriosis is a rare but severe infection. It manifests as vascular infections and endocarditis, mostly in older patients with vascular or cardiac valve prosthetic devices and co-morbidities. Mortality in Lm-associated endocarditis is twice higher than with other pathogens, requiring prompt recognition and treatment.
Sections du résumé
BACKGROUND
Listeria monocytogenes-associated endovascular infections are not well characterized.
METHODS
Retrospective study of 71 culture-proven cases reported to the French National Reference Center for Listeria from 1993 to 2018.
RESULTS
Seventy-one cases were identified: 42 with vascular aneurysms/prosthetic infections, 27 with endocarditis, 2 with both. Fifty-eight were men (82%); median age was 75 years [46-92]; 93% reported co-morbidities (66/71), including 50% with immunosuppressive conditions. Vascular infections consisted of infected aneurysms (68%) or prosthetic graft infections (32%); vascular rupture was reported in 25/42 (60%). Tissue samples grew L. monocytogenes in 98% (43/44) and blood cultures in 64% (27/42). Endocarditis cases involved prosthetic or native valves or intracardiac devices in respectively 62% (18/29), 28% (8/29) and 10% (3/29). Infected valves were aortic (62%, 16/26), mitral (31%, 8/26) or both (8%, 2/26); 38% patients required surgery; 45% displayed heart failure; 17% had concomitant neurolisteriosis. In-hospital mortality in vascular infections was 12% (5/42) and 41% (12/29) for Lm-associated endocarditis.
CONCLUSIONS
Endovascular listeriosis is a rare but severe infection. It manifests as vascular infections and endocarditis, mostly in older patients with vascular or cardiac valve prosthetic devices and co-morbidities. Mortality in Lm-associated endocarditis is twice higher than with other pathogens, requiring prompt recognition and treatment.
Identifiants
pubmed: 31376457
pii: S0163-4453(19)30238-5
doi: 10.1016/j.jinf.2019.07.013
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
322-331Informations de copyright
Copyright © 2019. Published by Elsevier Ltd.