Ann Lab Med 2018; 38(2): 102-109  https://doi.org/10.3343/alm.2018.38.2.102
Increasing Incidence of Listeriosis and Infection-associated Clinical Outcomes
Min Hyuk Choi, M.D.1,2, Yu Jin Park, M.D.1, Myungsook Kim, M.T.1, Young Hee Seo, B.S.1, Young Ah Kim, M.D.2, Jun Yong Choi, M.D.3, Dongeun Yong, M.D.1, Seok Hoon Jeong, M.D.1, and Kyungwon Lee, M.D.1
Department of Laboratory Medicine and Research Institute of Bacterial Resistance1, Yonsei University College of Medicine, Seoul; Department of Laboratory Medicine2, National Health Insurance Service Ilsan Hospital, Goyang; Department of Internal Medicine and AIDS Research Institute3, Yonsei University College of Medicine, Seoul, Korea
Corresponding author: Jun Yong Choi
Department of Internal Medicine and AIDS Research Institute, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: +82-2-2228-1974
Fax: +82-2-393-6884
E-mail: seran@yuhs.ac
Co-corresponding author: Kyungwon Lee
Department of Laboratory Medicine, Severance Hospital, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: +82-2-2228-2446
Fax: +82-2-313-0956
E-mail: leekcp@yuhs.ac
Received: June 29, 2017; Revised: July 11, 2017; Accepted: November 7, 2017; Published online: March 1, 2018.
© Korean Society for Laboratory Medicine. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Listeriosis caused by Listeria monocytogenes has a high case-fatality rate (CFR) of approximately 20% to 30%. An increasing incidence of listeriosis has been reported in many countries recently. We investigated the annual incidence, clinical characteristics, and outcomes of listeriosis at three different hospitals in Korea and evaluated the effects of appropriate empiric antimicrobial treatments on patient outcomes.
Methods: We retrospectively collected the data of all culture-positive cases of human listeriosis from three hospitals of different sizes in Korea during 2006–2016 and calculated the annual number of cases and incidence per 100,000 admissions.
Results: A total of 58 patients with L. monocytogenes were included in this study. The incidence of listeriosis was significantly higher in 2013–2016 than in 2006–2012 (RR 3.1; 95% CI 1.79–5.36; P 〈 0.001), mainly because of an increase in patients over 60 years of age (RR 3.69; 95% CI 1.70–8.02; P 〈 0.001). Multivariate analysis showed that healthcare-associated infection (adjusted OR, 12.15; 95% CI, 2.56–86.01; P=0.004) and empirical treatment with first-line antimicrobial agents (adjusted OR, 0.08; 95% CI, 0.00–0.63; P=0.044) were associated with CFR.
Conclusions: Healthcare-associated infections caused by L. monocytogenes are associated with high CFR. Adequate initial empirical treatments could reduce CFR, suggesting that careful consideration of an empirical antimicrobial regimen is warranted for elderly or immunocompromised patients admitted to the hospital.
Keywords: Listeria monocytogenes, Listeriosis, Incidence, Outcome, Empirical treatment



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