Michka Shoai-Tehrani1, Benoit Pilmis1, Mylène M Maury2, Olivier Robineau3, Olivier Disson4, Gregory Jouvion5, Gabrielle Coulpier6, Pierre Thouvenot6, Hélène Bracq-Dieye6, Guillaume Valès6, Alexandre Leclercq6, Marc Lecuit7, Caroline Charlier8. 1. Institut Pasteur, French National Reference Center, WHO Collaborating Center for Listeria, Paris, France; Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Universitaire Necker-Enfants Malades, Paris, France. 2. Institut Pasteur, French National Reference Center, WHO Collaborating Center for Listeria, Paris, France; Institut Pasteur, Biology of Infection Unit, 28 rue du Dr Roux, 75015 Paris, France; INSERM U1117, Paris, France. 3. Centre Hospitalier Universitaire Tourcoing, Paris, France. 4. Institut Pasteur, French National Reference Center, WHO Collaborating Center for Listeria, Paris, France; INSERM U1117, Paris, France. 5. Institut Pasteur, Experimental Neuropathology Unit, Paris, France. 6. Institut Pasteur, French National Reference Center, WHO Collaborating Center for Listeria, Paris, France; Institut Pasteur, Biology of Infection Unit, 28 rue du Dr Roux, 75015 Paris, France. 7. Institut Pasteur, French National Reference Center, WHO Collaborating Center for Listeria, Paris, France; Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Institut Pasteur, Biology of Infection Unit, 28 rue du Dr Roux, 75015 Paris, France; INSERM U1117, Paris, France. Electronic address: marc.lecuit@pasteur.fr. 8. Institut Pasteur, French National Reference Center, WHO Collaborating Center for Listeria, Paris, France; Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Universitaire Necker-Enfants Malades, Paris, France; Institut Pasteur, Biology of Infection Unit, 28 rue du Dr Roux, 75015 Paris, France; INSERM U1117, Paris, France. Electronic address: caroline.charlier@pasteur.fr.
Abstract
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.
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.
Authors: Enrico M Zardi; Nunzio Montelione; Vincenzo Catanese; Teresa Gabellini; Marco Caricato; Domenico M Zardi; Francesco Spinelli; Francesco Stilo Journal: Exp Ther Med Date: 2022-06-06 Impact factor: 2.751