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

Michka Shoai-Tehrani (1, 2) , Benoit Pilmis (1, 2) , Mylène M Maury (3, 4) , Olivier Robineau (5) , Olivier Disson (3, 4, 6) , Grégory Jouvion (7) , Gabrielle Coulpier (3, 4, 6) , Pierre Thouvenot (3, 4, 6) , Hélène Bracq-Dieye (3, 4, 6) , Guillaume Vales (3, 4, 6) , Alexandre Leclercq (3, 4, 6) , Marc Lecuit (6, 3, 8, 2, 4) , Caroline Charlier (3, 2, 6, 4)

1 CNR - CCOMS - Laboratoire des Listeria, Centre National de Référence des Listeria, et Centre collaborateur de l’OMS pour la listériose d’origine alimentaire
2 Service des Maladies infectieuses et tropicales [CHU Necker]
3 CC-OMS / WHO-CC - Centre collaborateur de l'OMS Listeria / WHO Collaborating Centre Listeria
4 CNRL - Centre National de Référence Listeria - National Reference Center Listeria
5 Centre Hospitalier de Tourcoing
6 Biologie des Infections - Biology of Infection
7 Neuropathologie expérimentale - Experimental neuropathology
8 UPD5 - Université Paris Descartes - Paris 5

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). Endo-carditis 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.

Mots clés: Listeria monocytogenes; Listeriosis; Prosthesis; Aneurysm; Endocarditis

Domaines: Sciences du Vivant [q-bio]; Médecine humaine et pathologie; Maladies infectieuses; Microbiologie et Parasitologie; Bactériologie

Michka Shoai-Tehrani, Benoit Pilmis, Mylène M Maury, Olivier Robineau, Olivier Disson, et al.. Listeria monocytogenes -associated endovascular infections: A study of 71 consecutive cases. Journal of Infection, 2019, 79 (4), pp.322 - 331. ⟨10.1016/j.jinf.2019.07.013⟩. ⟨pasteur-02448284⟩