caa a22 4500 606155597 CHVBK 20210128100604.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10096-015-2346-5 doi (NATIONALLICENCE)springer-10.1007/s10096-015-2346-5 The clinical features, diagnosis, treatment, and prognosis of neuroinvasive listeriosis: a multinational study [Elektronische Daten] [F. Arslan, E. Meynet, M. Sunbul, O. Sipahi, B. Kurtaran, S. Kaya, A. Inkaya, P. Pagliano, G. Sengoz, A. Batirel, B. Kayaaslan, O. Yıldız, T. Güven, N. Türker, İ. Midi, E. Parlak, S. Tosun, S. Erol, A. Inan, N. Oztoprak, I. Balkan, Y. Aksoy, B. Ceylan, M. Yılmaz, A. Mert] The aim of this study was to determine the independent risk factors, morbidity, and mortality of central nervous system (CNS) infections caused by Listeria monocytogenes. We retrospectively evaluated 100 episodes of neuroinvasive listeriosis in a multinational study in 21 tertiary care hospitals of Turkey, France, and Italy from 1990 to 2014. The mean age of the patients was 57 years (range, 19-92 years), and 64% were males. The all-cause immunosuppression rate was 54% (54/100). Forty-nine (49%) patients were referred to a hospital because of the classical triad of symptoms (fever, nuchal rigidity, and altered level of consciousness). Rhombencephalitis was detected radiologically in 9 (9%) cases. Twenty-seven (64%) of the patients who had cranial magnetic resonance imaging (MRI) performed had findings of meningeal and parenchymal involvement. The mean delay in the initiation of specific treatment was 6.8 ± 7 days. Empiric treatment was appropriate in 52 (52%) patients. The mortality rate was 25%, while neurologic sequelae occurred in 13% of the patients. In the multivariate analysis, delay in treatment [odds ratio (OR), 1.07 [95% confidence interval (CI), 1.01-1.16]] and seizures (OR, 3.41 [95% CI, 1.05-11.09]) were significantly associated with mortality. Independent risk factors for neurologic sequelae were delay in treatment (OR, 1.07 [95% CI, 1.006-1.367]) and presence of bacteremia (OR, 45.2 [95% CI, 2.73-748.1]). Delay in the initiation of treatment of neuroinvasive listeriosis was a poor risk factor for unfavorable outcomes. Bacteremia was one of the independent risk factors for morbidity, while the presence of seizures predicted worse prognosis. Moreover, the addition of aminoglycosides to ampicillin monotherapy did not improve patients' prognosis. Springer-Verlag Berlin Heidelberg, 2015 Arslan F. Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University Hospital, Istanbul, Turkey aut Meynet E. Pôle thorax et vaisseaux, Unité d'oncologie thoracique, CHU Grenoble, BP217, 38043, Grenoble cedex 9, France aut Sunbul M. Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey aut Sipahi O. Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Izmir, Turkey aut Kurtaran B. Department of Infectious Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey aut Kaya S. Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey aut Inkaya A. Department of Infectious Diseases, School of Medicine, Hacettepe University, Ankara, Turkey aut Pagliano P. Department of Infectious Diseases, D. Cotugno Hospital, AORN Dei Colli, Naples, Italy aut Sengoz G. Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey aut Batirel A. Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey aut Kayaaslan B. Clinic of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey aut Yıldız O. Department of Infectious Diseases, School of Medicine, Erciyes University, Kayseri, Turkey aut Güven T. Infectious Diseases and Clinical Microbiology Clinic, Ataturk Training and Research Hospital, Ankara, Turkey aut Türker N. Department of Infectious Diseases, İzmir Katip Çelebi University Atatürk Research and Education Hospital, Izmir, Turkey aut Midi İ. Department of Neurology, Marmara University Hospital, Istanbul, Turkey aut Parlak E. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey aut Tosun S. Izmir Bozyaka Research and Education Hospital, Izmir, Turkey aut Erol S. Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Education and Training Hospital, Istanbul, Turkey aut Inan A. Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Education and Training Hospital, Istanbul, Turkey aut Oztoprak N. Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Karaelmas University, Zonguldak, Turkey aut Balkan I. Department of Infectious Diseases and Clinical Microbiology, School of Cerrahpasa Medicine Faculty, Istanbul University, Istanbul, Turkey aut Aksoy Y. Infectious Diseases and Clinical Microbiology, Gebze State Hospital, Gebze, Turkey aut Ceylan B. Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey aut Yılmaz M. Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey aut Mert A. Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University Hospital, Istanbul, Turkey aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/6(2015-06-01), 1213-1221 0934-9723 34:6<1213 2015 34 10096 https://doi.org/10.1007/s10096-015-2346-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2346-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Arslan F. Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Meynet E. Pôle thorax et vaisseaux, Unité d'oncologie thoracique, CHU Grenoble, BP217, 38043, Grenoble cedex 9, France aut NATIONALLICENCE 700 1- Sunbul M. Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Samsun, Turkey aut NATIONALLICENCE 700 1- Sipahi O. Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, Izmir, Turkey aut NATIONALLICENCE 700 1- Kurtaran B. Department of Infectious Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey aut NATIONALLICENCE 700 1- Kaya S. Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey aut NATIONALLICENCE 700 1- Inkaya A. Department of Infectious Diseases, School of Medicine, Hacettepe University, Ankara, Turkey aut NATIONALLICENCE 700 1- Pagliano P. Department of Infectious Diseases, D. Cotugno Hospital, AORN Dei Colli, Naples, Italy aut NATIONALLICENCE 700 1- Sengoz G. Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Batirel A. Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Kayaaslan B. Clinic of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey aut NATIONALLICENCE 700 1- Yıldız O. Department of Infectious Diseases, School of Medicine, Erciyes University, Kayseri, Turkey aut NATIONALLICENCE 700 1- Güven T. Infectious Diseases and Clinical Microbiology Clinic, Ataturk Training and Research Hospital, Ankara, Turkey aut NATIONALLICENCE 700 1- Türker N. Department of Infectious Diseases, İzmir Katip Çelebi University Atatürk Research and Education Hospital, Izmir, Turkey aut NATIONALLICENCE 700 1- Midi İ. Department of Neurology, Marmara University Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Parlak E. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey aut NATIONALLICENCE 700 1- Tosun S. Izmir Bozyaka Research and Education Hospital, Izmir, Turkey aut NATIONALLICENCE 700 1- Erol S. Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Education and Training Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Inan A. Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Education and Training Hospital, Istanbul, Turkey aut NATIONALLICENCE 700 1- Oztoprak N. Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Karaelmas University, Zonguldak, Turkey aut NATIONALLICENCE 700 1- Balkan I. Department of Infectious Diseases and Clinical Microbiology, School of Cerrahpasa Medicine Faculty, Istanbul University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Aksoy Y. Infectious Diseases and Clinical Microbiology, Gebze State Hospital, Gebze, Turkey aut NATIONALLICENCE 700 1- Ceylan B. Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Yılmaz M. Infectious Diseases and Clinical Microbiology, Istanbul Medipol University, Istanbul, Turkey aut NATIONALLICENCE 700 1- Mert A. Department of Infectious Diseases and Clinical Microbiology, Istanbul Medipol University Hospital, Istanbul, Turkey aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/6(2015-06-01), 1213-1221 0934-9723 34:6<1213 2015 34 10096