Listeria monocytogenes infections in the adult. Clinical and microbiological issues of a changing disease

Thirty-one cases of human listeriosis seen from 1971-1999 were reviewed. ca ses were grouped as follows: Group I composed of 14 patients were studied i n the period 1971-1984; and group II composed of 17 cases studied in the pe riod 1985-1999. We tried to assess changes in the incidence, clinical findi ngs and outcome in both periods. The incidence of listeriosis remained cons tant along the years, 1.2 cases/20,000 discharges. The mean age of the patients significantly increased along the years (55 +/ - 11 years versus 68 +/- 12 years; p 0.002). 77% of cases had one or more u nderlying diseases predisposing to listeriosis. We observed an increasing n umber of listeriosis in patients without chronic diseases in recent years. Listeriosis presented as meningitis or primary sepsis. Mortality was 61% an d was strictly associated with the severity of the underlying disease. Pati ents with meningoencephalitis and seizures had a worse prognosis. We did no t observe differences in mortality of patients who were treated with beta-l actam monotherapy in comparison with those who were treated with beta-lacta m/aminoglucoside combination. Cotrimoxazole was uniformly successful treatm ent of human listeriosis in this serie.