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Listeriosis in patients receiving biologic therapies

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Abstract

The evolution of inflammatory diseases has radically changed since the introduction of biologic therapies, such as tumour necrosis factor alpha inhibitors (anti-TNFα). They, therefore, represent a widely used therapeutic modality. Nevertheless, post-marketing studies reveal an increased risk of infection in patients taking these drugs, especially granulomatous infections such as listeriosis. We aimed to evaluate the reported cases of listeriosis in patients treated with biologic treatments. We used the United States Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) from 2004 to 2011. We also perform a literature review of previously reported cases of listeriosis in patients taking biologic therapies. We identified 266 cases of Listeria monocytogenes infection associated with biologic therapies. The majority of patients were receiving infliximab (77.1 %), followed by etanercept (11.7 %), adalimumab (9.8 %), rituximab (4.1 %), abatacept (0.4 %) and golimumab (0.4 %). Indications for the use of biologics were as follows: 47.7 % for rheumatologic diseases, 38 % for inflammatory bowel diseases, 3.4 % for haematological diseases and 10.5 % for other indications. Seventy-three percent of the patients were receiving concomitant immunosuppressant drugs, especially steroids (56 %) and methotrexate (31.6 %). The median time to the onset of infection was 184 days. Mortality rates range from 11.1 % in adalimumab-treated patients to 27.3 % in rituximab-treated patients (p = 0.7). Listeriosis is common in biologics-treated patients, especially related to infliximab use given concomitantly with other immunosuppressive therapies. Infections after treatment with biologics mostly occurred in the first year after initiating treatment.

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Acknowledgments

Dr. Bodro is the recipient of a research grant from the Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain, and a mobility grant from the Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC).

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. IDIBELL, Institute of Biomedical Research of Bellvitge Hospital, Infectious Diseases Department, Hospital Universitari de Bellvitge, University of Barcelona, 08907, L’Hospitalet de Llobregat, Barcelona, Spain

    M. Bodro

  2. Infectious Diseases Department, University of Queensland Centre for Clinical Research, Royal Brisbane and Women’s Hospital Complex, Brisbane, Australia

    M. Bodro & D. L. Paterson

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Correspondence to M. Bodro.

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Bodro, M., Paterson, D.L. Listeriosis in patients receiving biologic therapies. Eur J Clin Microbiol Infect Dis 32, 1225–1230 (2013). https://doi.org/10.1007/s10096-013-1873-1

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