PERINATAL LISTERIOSIS - A POPULATION-BASED MULTICENTER STUDY IN BARCELONA, SPAIN (1990-1996)

The aim off this study was to describe the incidence, epidemiology, cl inical presentation, and outcome of perinatal listeriosis for a 7-year period (1990-1996) based on data of an active population-based survei llance project implemented in the city of Barcelona, Spain. There were 30 cases (20.8%) associated with pregnancy (15 pregnant women, 13 neo nates, and 2 fetal deaths). The incidence of perinatal listeriosis var ied from 4.1 to 0 per 10,000 live births. The proportion of perinatal cases in relation to the total number of cases of listeriosis varied b etween 0 and 42%. Early-onset neonatal sepsis accounted for 12 of 13 l ive births. The mean age of infected pregnant women with listeriosis w as 30.1 +/- 2.0 years. Chorioamnionitis was the predominant clinical f orm (86.7%). Only two mothers had primary bacteremia by L. monocytogen es in the second trimester of pregnancy. Both infants were born health y, without signs of infection. One of these mothers was infected with the human immunodeficiency virus (HIV). Since January 1994, 12 strains were available for serotyping and phagotyping; 9 belonged to serovar 4b, 2 to serovar 1/2b, and 1 to serovar 1/2a. No outbreaks of L. monoc ytogenes infection occurred during the study period. The overall neona tal mortality rate was 7.7% among infected live births. All pregnant w omen were treated with ampicillin and none died. Early antenatal treat ment with ampicillin improves neonatal outcome and can result in the b irth of healthy babies.