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BioMed Research International
Volume 2013 (2013), Article ID 846186, 4 pages
http://dx.doi.org/10.1155/2013/846186
Research Article

Listeria monocytogenes Meningitis in Adults: The Czech Republic Experience

1Charles University in Prague, Third Faculty of Medicine, Department of Infectious Diseases, Na Bulovce Hospital, Budinova 2, 180 81 Prague, Czech Republic
2Charles University in Prague, First Faculty of Medicine, Department of Infectious Diseases, Na Bulovce Hospital, Budinova 2, 180 81 Prague, Czech Republic
3Charles University in Prague, Second Faculty of Medicine, Department of Infectious Diseases, Na Bulovce Hospital, Budinova 2, 180 81 Prague, Czech Republic

Received 25 April 2013; Accepted 13 August 2013

Academic Editor: Klaus P. Hunfeld

Copyright © 2013 Olga Dzupova et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Listeria monocytogenes (LM) is currently the third most frequent pathogen of bacterial meningitis in adults. Methods. A prospective study of patients with LM meningitis in a Czech tertiary care hospital, carried out from 1997 to 2012. Results. Thirty-one patients were diagnosed with LM meningitis, which was 7% of a total of 440 adult patients with acute bacterial meningitis (ABM) over a 16-year period. Their median age was 63 years, range 26–80 years. Nineteen patients (61%) had underlying immunocompromising comorbidity; 15 patients (48%) were older than 65 years. Fourteen patients (45%) had arterial hypertension. The typical triad of fever, neck stiffness, and altered mental status was present in 21 patients (68%). The median count of cerebrospinal fluid (CSF) leukocytes was 680/ L, protein level 2.6 g/L, and glucose ratio 0.28. Four patients (13%) died, and nine (29%) survived with moderate to severe sequelae. Conclusion. LM meningitis is known to affect immunosuppressed and elderly patients. Arterial hypertension seems to be another important predisposing factor. Clinical symptoms, CSF findings, and disease outcomes, did not significantly differ from other community-acquired ABM in our study, although the CSF leukocyte count was lower. Ampicillin showed good clinical and bacteriological efficacy in the majority of patients.