Listeria monocytogenes-associated endovascular infections: A study of 71 consecutive cases

J Infect. 2019 Oct;79(4):322-331. doi: 10.1016/j.jinf.2019.07.013. Epub 2019 Jul 31.

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.

Keywords: Aneurysm; Endocarditis; Listeria monocytogenes; Listeriosis; Prosthesis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm / microbiology
  • Endocarditis, Bacterial / epidemiology
  • Endocarditis, Bacterial / microbiology*
  • Endocarditis, Bacterial / mortality
  • Epidemiological Monitoring
  • Female
  • France / epidemiology
  • Heart Valve Prosthesis / microbiology
  • Hospital Mortality
  • Humans
  • Listeria monocytogenes / pathogenicity
  • Listeriosis / epidemiology
  • Listeriosis / microbiology*
  • Listeriosis / mortality
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors