Listeriosis in Patients at a Comprehensive Cancer Center, 1955-1997

Abstract

Listeria monocytogenes infection occurred in 94 patients during 1955-1997 at Memorial Sloan-Kettering Cancer Center. The incidence was 0.5 (1955-1966), 0.96 (1970-1979), and 0.14 (1985-1997) cases per 1000 new admissions. Eighty-five patients (90%) were bacteremic, and 34 (36%) had evidence of intracranial infection. In 91 patients with cancer, 70 (77%) received chemotherapy for advanced or relapsed malignancy (n=51; 56%); 64 (68%) received corticosteroids. Breast cancer was the most common solid-organ cancer (n=14; 45%), and 34 (36%) had preexisting advanced liver disease. In 14 (39%) of 37 patients who died of listeriosis, death occurred within 48 h of L. monocytogenes isolation. Four (80%) of 5 patients with extracranial foci of infection died of their infection, compared with 33 (37%) of 89 patients with isolated bacteremia and/or intracranial infection (odds ratio, 2.34; P=.05). Most infections (60%) were due to L. monocytogenes serotype 1/2, and the remainder (40%) were due to serovar 4b. Listeriosis in these patients with cancer occurred most often in individuals receiving antineoplastic therapy for advanced or relapsed malignancy and systemic corticosteroids. The presence of advanced liver disease may have increased the risk of systemic listeriosis in susceptible patients with underlying cancer.

Prosthetic valve endocarditis due to Listeria monocytogenes

“…70,71,73 However, in vivo synergism has not been uniformly observed and retrospective clinical studies have not consistently shown better results for combined therapy of listeriosis than simple penicillin monotherapy. 3,4,70,74 In this review, 23 of 35 (65.7%) patients with listerial endocarditis treated with the combination of penicillin or ampicillin with aminoglycosides survived the infection in comparison with ten out of 14 (71.4%) treated with penicillin monotherapy. The combination of vancomicin with gentamicin was successfully used in four patients including one in the above case studies.…”

“…2 Endocarditis is a rare complication of bacteremia due to Listeria and in the most recent series on listeriosis in adults, cases of endocarditis were not found. 3,4 However, infections occurring both on natural and prosthetic valves have been reported. 5,6 Due to the scarcity of these reports, the clinical manifestations, optimal treatment and outcome of listerial endocarditis have not been completely ascertained.…”

Characterization of antibiotic resistance in Listeria spp. isolated from slaughterhouse environments, pork and human infections

“…The disease primarily affects the elderly, neonates, and immunocompromised individuals, which includes an increasing population of cancer and HIV-positive patients [1,5,6]. A positive outcome for listeriosis depends on the early administration of antibiotics.…”

The Occurrence and Prevention of Foodborne Disease in Vulnerable People

“…Currently, TMP-SMX is used in many transplant centers for varying durations (3 months to as long as a lifetime) primarily to prevent Pneumocystis pneumonia, and this combination is also effective against L. monocytogenes and T. gondii (Marty and Rubin, 2006;Fishman 2007;del Pozo, 2008;Muñ oz et al, 2010). The great majority of L. monocytogenes isolates from clinical and food sources were susceptible to TMP-SMX, but a very few isolates were resistant (Safdar and Armstrong, 2003;Conter et al, 2009;Morvan et al, 2010). Alternative prophylactic agents against Pneumocystis may have less activity against L. monocytogenes (Baden et al, 2001).…”