Invasive Listeriosis at Intensive Care Units: Review of a series of cases

Abstract

Clinical characteristics of patients admitted to a general Intensive Care Unit in Montevideo (Uruguay) due to Listeria monocytogenes infections are described. It is a retrospective study of cases admitted at the mentioned intensive care unit, during a period of three years from July 2010 to July 2013. All confirmed cases of invasive listeriosis were included. A descriptive analysis of the variables of interest was performed. Eleven cases of invasive listeriosis were identified, 6 were men, 5 women. Mean age was 62 years with a standard deviation (SD) ± 12 years ranged from 22 to 83 years. Mean APACHE II was 23 with SD ± 9. The median length of stay at ICU was 8 days with an interquartile range of 6. Mechanical ventilation was required in 81.8% cases. Diabetes mellitus, neoplasic disease, alcoholism, immunosuppression, prior corticosteroids therapy and age were predisposing factors detected in these patients. The presenting forms were five as meningoencephalitis, three primary bacteremia, one with a central venous catheter infection, one in an obstetric patient and one as a spontaneous peritonitis in a cirrhotic patient. At least one of the predisposing factors mentioned previously were identified in all of the cases. The most commonly used antibiotic was ampicillin. Overall mortality was 63%. We concluded that Invasive Listeriosis is an opportunistic infectious disease that usually appears in patients with one or more associated risk factors. The most common presentation is as a central nervous system infection and it is associated with high mortality rates.