Abstract
Purpose
Various immunocompromised conditions increase the risk of meningitis caused by Listeria monocytogenes. However, the relative importance of these risk factors has not been well established. We determined the risk factors that predict meningitis due to L. monocytogenes compared to that caused by Streptococcus pneumoniae.
Methods
A nationwide multicenter case–control study was conducted in Korea. Cases of meningitis caused by L. monocytogenes between 1998 and 2013 were included. Patients with pneumococcal meningitis were included as controls. Multivariate logistic regression analysis was used to predict the risk factors of Listeria meningitis.
Results
A total of 36 cases and 113 controls were enrolled. The most significant predictive risk factor of Listeria meningitis was a prior history of receiving immunosuppressive therapy (odds ratio 8.12, 95 % CI 2.47–26.69). Chronic liver disease was the second most important predictive risk factor (OR 5.03, 95 % CI 1.56–16.22). Delaying appropriate antibiotic therapy by more than 6 h (hazard ratio 2.78) and fatal underlying disease (hazard ratio 2.88) were associated with increased mortality.
Conclusions
Patients with a prior history of receiving immunosuppressive therapy within 1 month and chronic liver disease have 8.1-fold and 5-fold increased risk of meningitis by L. monocytogenes compared to S. pneumoniae, respectively.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Maertens de Noordhout C, Devleesschauwer B, Angulo FJ, Verbeke G, Haagsma J, Kirk M, Havelaar A, Speybroeck N. The global burden of listeriosis: a systematic review and meta-analysis. Lancet Infect Dis. 2014;14:1073–82.
Disson O, Lecuit M. Targeting of the central nervous system by Listeria monocytogenes. Virulence. 2012;3:213–21.
van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med. 2004;351:1849–59.
Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, Harrison LH, Farley MM, Reingold A, Bennett NM, Craig AS, Schaffner W, Thomas A, Lewis MM, Scallan E, Schuchat A. Bacterial meningitis in the United States, 1998–2007. N Engl J Med. 2011;364:2016–25.
Moon SY, Chung DR, Kim SW, Chang HH, Lee H, Jung DS, Kim YS, Jung SI, Ryu SY, Heo ST, Moon C, Ki HK, Son JS, Kwon KT, Shin SY, Lee JS, Lee SS, Rhee JY, Lee JA, Joung MK, Cheong HS, Peck KR, Song JH. Changing etiology of community-acquired bacterial meningitis in adults: a nationwide multicenter study in Korea. Eur J Clin Microbiol Infect Dis. 2010;29:793–800.
Brouwer MC, van de Beek D, Heckenberg SG, Spanjaard L, de Gans J. Community-acquired Listeria monocytogenes meningitis in adults. Clin Infect Dis. 2006;43:1233–8.
Adriani KS, Brouwer MC, van de Beek D. Risk factors for community-acquired bacterial meningitis in adults. Neth J Med. 2015;73:53–60.
Mc CW, Jackson G. Gram-negative bacteremia: I. Etiology and ecology. Arch Intern Med. 1962;110:847–55.
Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992;101:1644–55.
Stahre M, Naimi T, Brewer R, Holt J. Measuring average alcohol consumption: the impact of including binge drinks in quantity–frequency calculations. Addiction. 2006;101:1711–8.
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement. M100-S24. Wayne, PA, USA:CLSI; 2014.
Laguna-Del Estal P, Lledo-Ibanez GM, Rios-Garces R, Pintos-Pascual I. Meningitis due to Listeria monocytogenes in adults. Rev Neurol. 2013;56:13–8.
Brouwer MC, Tunkel AR, van de Beek D. Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. Clin Microbiol Rev. 2010;23:467–92.
Pagliano P, Attanasio V, Rossi M, Carleo MA, Carannante N, Ascione T, Tuccillo F, Fraganza F. Listeria monocytogenes meningitis in the elderly: distinctive characteristics of the clinical and laboratory presentation. J Infect. 2015;71:134–6.
Arslan F, Meynet E, Sunbul M, Sipahi OR, Kurtaran B, Kaya S, Inkaya AC, Pagliano P, Sengoz G, Batirel A, Kayaaslan B, Yildiz O, Guven T, Turker N, Midi I, Parlak E, Tosun S, Erol S, Inan A, Oztoprak N, Balkan I, Aksoy Y, Ceylan B, Yilmaz M, Mert A. The clinical features, diagnosis, treatment, and prognosis of neuroinvasive listeriosis: a multinational study. Eur J Clin Microbiol Infect Dis. 2015;34:1213–21.
Bartlett JG. Listeria monocytogenes. In: Johns Hopkins antibiotic (ABX) guide. Johns Hopkins Medicine. 2016. http://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540318/all/Listeria_Monocytogenes. Accessed 03 July 2016.
Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Schel WM, Whitley RJ. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39:1267–84.
Koopmans MM, Brouwer MC, Bijlsma MW, Bovenkerk S, Keijzers W, van der Ende A, van de Beek D. Listeria monocytogenes sequence type 6 and increased rate of unfavorable outcome in meningitis: epidemiologic cohort study. Clin Infect Dis. 2013;57:247–53.
Acknowledgments
This study was supported by a grant from the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (Grant No. HI12C0756).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
This study was approved by the Samsung Medical Center Institutional Review Board (2008-06-052-001).
Conflict of interest
All authors have nothing to declare.
Rights and permissions
About this article
Cite this article
Lim, S., Chung, D.R., Kim, YS. et al. Predictive risk factors for Listeria monocytogenes meningitis compared to pneumococcal meningitis: a multicenter case–control study. Infection 45, 67–74 (2017). https://doi.org/10.1007/s15010-016-0939-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15010-016-0939-2