Shari Sapuan1, Christina Kortsalioudaki2, Mark Anthony3, John Chang4, Nicholas D Embleton5, Ruppa M Geethanath6, Jim Gray7, Anne Greenough8, Mithilesh K Lal9, Suzanne Luck10, Santosh Pattnayak11, Peter Reynolds12, Allison B Russell13, Timothy Scorrer14, Mark Turner15, Paul T Heath16, Stefania Vergnano17. 1. Paediatric Infectious Diseases Research Group, St George's University of London, Jenner Wing, Level 2, Room 2.215E, Mail Point J2C, London, SW17 0RE, UK. Electronic address: sharisapuan@doctors.org.uk. 2. Paediatric Infectious Diseases Research Group, St George's University of London, Jenner Wing, Level 2, Room 2.215E, Mail Point J2C, London, SW17 0RE, UK. Electronic address: ckortsal@sgul.ac.uk. 3. Children's Services, John Radcliffe Hospital, Oxford University Hospitals NHSFT, Newborn Care Unit, Headington, Oxford, OX3 9DU, UK. Electronic address: anthony.mark@ouh.nhs.uk. 4. Croydon Health Services NHS Trust, St George's University of London, Croydon University Hospital, 530 London Rd, Croydon, Surrey, CR7 7YE, UK. Electronic address: john.chang@croydonhealth.nhs.uk. 5. Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP, UK. Electronic address: nicholas.embleton@newcastle.ac.uk. 6. City Hospital Sunderland NHSFT, Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP, UK. Electronic address: ruppa.geethanath@chsft.nhs.uk. 7. Birmingham Children's Hospital NHSFT, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK. Electronic address: jim.gray@bch.nhs.uk. 8. King's College London, King's Health Partners, Royal College of Paediatrics and Child Health, Neonatal Intensive Care Unit, King's College Hospital, 4th Floor Golden Jubilee Wing, Denmark Hill, SE5 9RS, UK. Electronic address: anne.greenough@kcl.ac.uk. 9. Department of Neonatal Medicine, The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK. Electronic address: mithilesh.lal@stees.nhs.uk. 10. Kingston Hospital NHS Trust, Galsworthy Rd, Kingston upon Thames, KT2 7QB, UK. Electronic address: suzanne.luck@nhs.net. 11. Kent Neonatal Transport Service, Medway NHS Foundation Trust, Gillingham Kent, ME7 5NY, UK. Electronic address: santosh.pattnayak@medway.nhs.uk. 12. Department of Paediatrics, St. Peter's Hospital, Ashford and St. Peter's Hospitals NHSFT, Royal Holloway University of London, Surrey & Sussex Neonatal ODN, Guildford Road, Surrey, KT16 0PZ, UK. Electronic address: peter.reynolds@asph.nhs.uk. 13. Birmingham Women's NHSFT, West Midlands Maternity and Children's Strategic Clinical Network, Mindelsohn Way, Birmingham, B15 2TG, UK. Electronic address: alison.bedfordrussell@nhs.net. 14. Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Southwick Hill Road, Portsmouth, PO6 3LY, UK. Electronic address: tim.scorrer@porthosp.nhs.uk. 15. Women's and Children's Health, University of Liverpool, Liverpool Women's NHSFT, Institute of Translational Medicine, Crown St, Liverpool, L8 7SS, UK. Electronic address: mark.turner@liverpool.ac.uk. 16. Paediatric Infectious Diseases Research Group, St George's University of London, Jenner Wing, Level 2, Room 2.215E, Mail Point J2C, London, SW17 0RE, UK. Electronic address: pheath@sgul.ac.uk. 17. Paediatric Infectious Diseases Research Group, St George's University of London, Jenner Wing, Level 2, Room 2.215E, Mail Point J2C, London, SW17 0RE, UK; Paediatric Infectious Diseases, Bristol Royal Hospital for Children, University of Bristol, Level 6, UH Bristol Education and Research Centre, Upper Maudlin Street, Bristol BS2 8AE, UK. Electronic address: svergnan@sgul.ac.uk.
Abstract
OBJECTIVE: To define the clinical features and outcomes of neonatal listeriosis, and identify the maternal risk factors to seek scope for improvement. METHODS: Neonatal listeriosis was identified prospectively from a United Kingdom neonatal infection surveillance network (neonIN) between 2004 and 2014. The participating neonatal units completed a study-specific proforma. RESULTS: The incidence of neonatal listeriosis was 3.4 per 100,000 live births. Of the 21 cases identified, 19 were confirmed with a median gestational age of 33 weeks and a median birth weight of 1960 g. The majority had clinical features (95%, 18/19), presented within the first 24 h (95%, 18/19), and received penicillin empirically (94%, 18/19). The neonatal case-fatality rate was 21% (24% if probable cases were included). A proportion of mothers were investigated (60%, 12/18) and diagnosed with listeriosis (58%, 7/12); 32% (6/19) were treated with antibiotics but only 33% (6/12) included penicillin. DISCUSSION: Despite its rarity and the prompt and appropriate use of antibiotics neonatal listeriosis has a high case-fatality rate. There is room for improvement in the adherence to the empiric antibiotic choice for puerperal sepsis, according to the national guidelines as this, would target listeriosis. Strategies should be in place to prevent pregnancy-associated listeriosis in higher risk population.
OBJECTIVE: To define the clinical features and outcomes of neonatal listeriosis, and identify the maternal risk factors to seek scope for improvement. METHODS: Neonatal listeriosis was identified prospectively from a United Kingdom neonatal infection surveillance network (neonIN) between 2004 and 2014. The participating neonatal units completed a study-specific proforma. RESULTS: The incidence of neonatal listeriosis was 3.4 per 100,000 live births. Of the 21 cases identified, 19 were confirmed with a median gestational age of 33 weeks and a median birth weight of 1960 g. The majority had clinical features (95%, 18/19), presented within the first 24 h (95%, 18/19), and received penicillin empirically (94%, 18/19). The neonatal case-fatality rate was 21% (24% if probable cases were included). A proportion of mothers were investigated (60%, 12/18) and diagnosed with listeriosis (58%, 7/12); 32% (6/19) were treated with antibiotics but only 33% (6/12) included penicillin. DISCUSSION: Despite its rarity and the prompt and appropriate use of antibiotics neonatal listeriosis has a high case-fatality rate. There is room for improvement in the adherence to the empiric antibiotic choice for puerperal sepsis, according to the national guidelines as this, would target listeriosis. Strategies should be in place to prevent pregnancy-associated listeriosis in higher risk population.
Authors: Bahaa Abu-Raya; Marianne Jost; Julie A Bettinger; Robert Bortolussi; Janet Grabowski; Thierry Lacaze-Masmonteil; Joan L Robinson; Klara M Posfay-Barbe; Eleni Galanis; Elizabeth Schutt; Mirjam Mäusezahl; Tobias R Kollmann Journal: Paediatr Child Health Date: 2021-06-19 Impact factor: 2.600