BACKGROUND: Listeria monocytogenes (LM) is currently the third most frequent pathogen of bacterial meningitis in adults. METHODS: A prospective study of patients with LM meningitis in a Czech tertiary care hospital, carried out from 1997 to 2012. RESULTS: Thirty-one patients were diagnosed with LM meningitis, which was 7% of a total of 440 adult patients with acute bacterial meningitis (ABM) over a 16-year period. Their median age was 63 years, range 26-80 years. Nineteen patients (61%) had underlying immunocompromising comorbidity; 15 patients (48%) were older than 65 years. Fourteen patients (45%) had arterial hypertension. The typical triad of fever, neck stiffness, and altered mental status was present in 21 patients (68%). The median count of cerebrospinal fluid (CSF) leukocytes was 680/μL, protein level 2.6 g/L, and glucose ratio 0.28. Four patients (13%) died, and nine (29%) survived with moderate to severe sequelae. CONCLUSION: LM meningitis is known to affect immunosuppressed and elderly patients. Arterial hypertension seems to be another important predisposing factor. Clinical symptoms, CSF findings, and disease outcomes, did not significantly differ from other community-acquired ABM in our study, although the CSF leukocyte count was lower. Ampicillin showed good clinical and bacteriological efficacy in the majority of patients.

Charles University Prague 3rd Faculty of Medicine Department of Infectious Diseases Na Bulovce Hospital Budinova 2 180 81 Prague Czech Republic

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Amaya-Villar R, García-Cabrera E, Sulleiro-Igual E, et al. Three-year multicenter surveillance of community-acquired Listeria monocytogenes meningitis in adults. BMC Infectious Diseases. 2010;10, article 324 PubMed PMC

Brouwer MC, van de Beek D, Heckenberg SGB, Spanjaard L, de Gans J. Community-acquired Listeria monocytogenes meningitis in adults. Clinical Infectious Diseases. 2006;43(10):1233–1238. PubMed

Dzupova O, Rozsypal H, Prochazka B, Benes J. Acute bacterial meningitis in adults: predictors of outcome. Scandinavian Journal of Infectious Diseases. 2009;41(5):348–354. PubMed

Mylonakis E, Hohmann EL, Calderwood SB. Central nervous system infection with Listeria monocytogenes: 33 years’ experience at a general hospital and review of 776 episodes from the literature. Medicine. 1998;77(5):313–336. PubMed

Siegman-Igra Y, Levin R, Weinberger M, et al. Listeria monocytogenes infection in Israel and review of cases worldwide. Emerging Infectious Diseases. 2002;8(3):305–310. PubMed PMC

van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M. Clinical features and prognostic factors in adults with bacterial meningitis. The New England Journal of Medicine. 2004;351(18):1849–1923. PubMed

Teasdale GM, Pettigrew LEL, Wilson JTL, Murray G, Jennett B. Analyzing outcome of treatment of severe head injury: a review and update on advancing the use of the Glasgow Outcome Scale. Journal of Neurotrauma. 1998;15(8):587–597. PubMed

National Institute of Public Health, Czech Republic. Infectious diseases report database. http://www.szu.cz/tema/prevence/infekcni-nemoci.

Fernández Guerrero ML, Torres R, Mancebo B, et al. Antimicrobial treatment of invasive non-perinatal human listeriosis and the impact of the underlying disease on prognosis. Clinical Microbiology and Infection. 2012;18(7):690–695. PubMed

Gerner-Smidt P, Ethelberg S, Schiellerup P, et al. Invasive listeriosis in Denmark 1994–2003: a review of 299 cases with special emphasis on risk factors for mortality. Clinical Microbiology and Infection. 2005;11(8):618–624. PubMed

Goulet V, Marchetti P. Listeriosis in 225 non-pregnant patients in 1992: clinical aspects and outcome in relation to predisposing conditions. Scandinavian Journal of Infectious Diseases. 1996;28(4):367–374. PubMed

Julián A, Jiménez Á, de Górgolas M, Fernández R, Fernández ML. Infecciones por Listeria monocytogenes en el adulto. Aspectos clínicos y microbiológicos de una enfermedad cambiante. Enfermedades Infecciosas y Microbiología Clínica. 2001;19(7):297–303. PubMed

Mitjà O, Pigrau C, Ruiz I, et al. Predictors of mortality and impact of aminoglycosides on outcome in listeriosis in a retrospective cohort study. Journal of Antimicrobial Chemotherapy. 2009;64(2):416–423. PubMed

Swaminathan B, Gerner-Smidt P. The epidemiology of human listeriosis. Microbes and Infection. 2007;9(10):1236–1243. PubMed

Dzupova O, Polivkova S, Smiskova D, Benes J. Epidemiological, clinical and laboratory characteristics of bacterial meningitis in adult patients. Klinická Mikrobiologie a Infekční Lékařství. 2010;16(2):58–63. PubMed

van de Beek D, de Gans J, Tunkel AR, Wijdicks EFM. Community-acquired bacterial meningitis in adults. The New England Journal of Medicine. 2006;354(1):44–53. PubMed

Clauss HE, Lorber B. Central nervous system infection with Listeria monocytogenes . Current Infectious Disease Reports. 2008;10(4):300–306. PubMed

Lorber B. Listeriosis. Clinical Infectious Diseases. 1997;24(1):1–11. PubMed

Hof H. An update on the medical management of listeriosis. Expert Opinion on Pharmacotherapy. 2004;5(8):1727–1735. PubMed

Merle-Melet M, Dossou-Gbete L, Maurer P, et al. Is amoxicillin-cotrimoxazole the most appropriate antibiotic regimen for Listeria meningoencephalitis? Review of 22 cases and the literature. Journal of Infection. 1996;33(2):79–85. PubMed