Clinical analysis of 26 cases of maternal or neonatal listeriosis
10.3760/cma.j.issn.1007-9408.2019.12.008
- VernacularTitle: 孕产妇与新生儿李斯特菌病26例临床分析
- Author:
Yanli SHI
1
;
Junwen YANG
2
;
Chunyan GAO
3
;
Mingyuan JIAO
4
;
Shulan ZUO
5
;
Jingzheng LIU
6
;
Jianning WU
7
;
Bin MA
8
;
Shuchen ZHANG
1
;
Xueqing LI
1
;
Dong LI
1
;
Binghuai LU
9
Author Information
1. Clinical Laboratory, Civil Aviation General Hospital, Beijing 100123, China
2. Clinical Laboratory, Zhengzhou Children's Hospital, Zhengzhou 450053, China
3. Clinical Laboratory, Tangshan Maternal and Child Health Hospital, Tangshan 063000, China
4. Clinical Laboratory, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing 101101, China
5. Clinical Laboratory, the Fourth Hospital of Tianshui City, Tianshui 741020, China
6. Clinical Laboratory, Beijing Tiantan Hospital, Beijing 100070, China
7. Clinical Laboratory Center, Xiamen Humanity Hospital, Xiamen 361003, China
8. Department of Obstetrics and Gynecology, Civil Aviation General Hospital, Beijing 100123, China
9. Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing 100029, China
- Publication Type:Clinical Trail
- Keywords:
Pregnancy complications, infectious;
Listeriosis;
Pregnancy outcome;
Infant, newborn
- From:
Chinese Journal of Perinatal Medicine
2019;22(12):878-884
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To improve clinical management of maternal and neonatal listeriosis through analyzing the clinical characteristics and antibiotic treatment.
Methods:A retrospective analysis of 26 cases of listeriosis, including their demographic and clinical features, was conducted, involving 16 pregnant women from Civil Aviation General Hospital, Xiamen Humanity Hospital, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing Tiantan Hospital, Tangshan Maternal and Child Health Hospital, the Fourth Hospital of Tianshui City from October, 2011 to May, 2018, and 10 newborns from the Fourth Hospital of Tianshui City, Tangshan Maternal and Child Health Hospital, Zhengzhou Children's Hospital from February, 2016 to April 2018. Descriptive methods were used for data analysis.
Results:(1) Among the 16 gravidas, one, five and 10 developed the infection in the 1st, 2nd and 3rd trimester of pregnancy, respectively, and eight had pregnancy complications. Furthermore, all of them developed fever [(38.9±0.5) ℃]. Symptoms such as cough, nasal congestion, runny nose, sore throat, dizziness, headache and other flu-like symptoms were observed in six cases. Gastrointestinal symptoms and flu-like symptoms were presented in four. Fetal distress, tachycardia and decreased fetal movement occurred in 11 cases. Elevated C-reactive protein and white blood cell count were detected in 16 and 14, respectively. Eight underwent placental pathological examination which shown various degrees of pathological changes, including neutrophil infiltration, acute chorioamnionitis and inflammatory necrosis. The main empirical antibiotic treatment for the 16 patients was cephalosporins and only four covered Listeria monocytogenes. Only two delivered at term, while the others (14/16) ended in miscarriage, premature delivery or stillbirth. (2) Among the 10 newborns with listeriosis, there were eight early-onset infections and two late-onset infections. All of them were febrile [(38.6±0.6)℃]. Six had cyanosis, groaning, foaming and three concave sign; five showed shortness of breath; meningitis and skin rash were found in one, respectively. All had elevated white blood cell and C-reactive protein. Six received antibiotics covering Listeria monocytogenes during the initial empirical treatment. Four were treated with cephalosporins alone, one of which died after the treatment was withdrawn. One was cured by initial treatment with meropenem alone, while eight recovered after adjustment of treatment with ampicillin, penicillin, meropenem, vancomycin alone, or meropenem combined with ampicillin or vancomycin. (3) The isolates that were susceptible to penicillin, ampicillin and meropenem accounted for 96.1% (25/26) all together and 88.5% (23/26) were susceptible to compound sulfamethoxazole.
Conclusions:There is no specific clinical manifestations of maternal or neonatal listeriosis. Maternal listeriosis is often characterized by acute onset and high incidence of adverse pregnancy outcomes.
