Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study

• Published in: The Lancet infectious diseases 2017-05, Vol.17 (5), p.510-519
• Main Authors: Charlier, Caroline, Dr, Perrodeau, Élodie, MSc, Leclercq, Alexandre, MSc, Cazenave, Benoît, MD, Pilmis, Benoît, MD, Henry, Benoît, MD, Lopes, Amanda, MD, Maury, Mylène M, PhD, Moura, Alexandra, PhD, Goffinet, François, MD, Dieye, Hélène Bracq, Thouvenot, Pierre, Ungeheuer, Marie-Noëlle, MD, Tourdjman, Mathieu, MD, Goulet, Véronique, MD, de Valk, Henriette, MD, Lortholary, Olivier, Prof, Ravaud, Philippe, Prof, Lecuit, Marc, Prof
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bacteremia; Bacteremia - epidemiology; Bacteremia - mortality; Bacterial infections; Brain stem; Cancer; Clinical trials; Clustering; Cohort analysis; Dexamethasone; Disease; Epidemiology; Female; Fetuses; Food; Foodborne diseases; Foodborne Diseases - microbiology; France - epidemiology; Genomes; Gestation; Health risk assessment; Hospitalization; Humans; Infant, Newborn; Infant, Newborn, Diseases - epidemiology; Infant, Newborn, Diseases - microbiology; Infections; Infectious Disease; Infectious Disease Transmission, Vertical; Infectious diseases; Life Sciences; Listeria; Listeria monocytogenes - classification; Listeria monocytogenes - isolation & purification; Listeriosis; Listeriosis - diagnosis; Listeriosis - epidemiology; Listeriosis - microbiology; Male; Mandatory Reporting; Medical prognosis; Meningitis; Meningoencephalitis; Meningoencephalitis - epidemiology; Meningoencephalitis - microbiology; Meningoencephalitis - mortality; Mortality; Neonates; Observational studies; Patients; Population Surveillance; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - microbiology; Prognosis; Prospective Studies; Public health; Regression analysis; Risk Factors; Studies; Surveillance; Windows (intervals)
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(16)30521-7

Summary Background Listeriosis is a severe foodborne infection and a notifiable disease in France. We did a nationwide prospective study to characterise its clinical features and prognostic factors. Methods MONALISA was a national prospective observational cohort study. We enrolled eligible cases declared to the National Reference Center for Listeria (all microbiologically proven) between Nov 3, 2009, and July 31, 2013, in the context of mandatory reporting. The outcomes were analysis of clinical features, characterisation of Listeria isolates, and determination of predictors of 3-month mortality or persisting impairment using logistic regression. A hierarchical clustering on principal components was also done for neurological and bacteraemic cases. The study is registered at ClinicalTrials.gov , number NCT01520597. Findings We enrolled 818 cases from 372 centres, including 107 maternal–neonatal infections, 427 cases of bacteraemia, and 252 cases of neurolisteriosis. Only five (5%) of 107 pregnant women had an uneventful outcome. 26 (24%) of 107 mothers experienced fetal loss, but never after 29 weeks of gestation or beyond 2 days of admission to hospital. Neurolisteriosis presented as meningoencephalitis in 212 (84%) of 252 patients; brainstem involvement was only reported in 42 (17%) of 252 patients. 3-month mortality was higher for bacteraemia than neurolisteriosis (hazard ratio [HR] 0·54 [95% CI 0·41–0·69], p