Outcome of Listeria monocytogenes prosthetic valve endocarditis: as bad as it looks?

Scand J Infect Dis. 2004;36(10):709-11. doi: 10.1080/00365540410021063.

Abstract

In 1998 we presented 1 successfully treated case of Listeria monocytogenes prosthetic valve endocarditis and made a review of all the cases that had been published to date. We carry out an up-to-date review through Pub-Med of every case of Listeria monocytogenes prosthetic valve endocarditis; mortality rate is calculated and data from several clinical and therapeutical variables are collected; Fisher's exact test is used to identify those variables significantly associated with mortality. Four out of 23 patients died in hospital (17%); among all the variables included, only peripheral embolism (p=0.024), onset on a mechanical prosthesis (p=0.035) and having used only 1 antibiotic instead of a combination of drugs (p=0.026) were independently associated with mortality. Although the overall number of cases is too low to draw definite conclusions (n=23), mortality rate is lower than previously believed. Some variables that have traditionally been associated with a poor prognosis for endocarditides are not for the case of Listeria monocytogenes on valvular prostheses. It seems prudent to treat affected patients with a combination of ampicillin -- or vancomycin, if there is a history of beta-lactam allergy and ampicillin desensitization is not possible -- plus an aminoglycoside.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents
  • Drug Therapy, Combination / therapeutic use
  • Endocarditis, Bacterial / diagnosis
  • Endocarditis, Bacterial / drug therapy
  • Endocarditis, Bacterial / etiology*
  • Female
  • Heart Valve Prosthesis / adverse effects*
  • Humans
  • Listeria monocytogenes / isolation & purification*
  • Listeriosis / diagnosis*
  • Listeriosis / drug therapy
  • Male
  • Middle Aged
  • Prognosis
  • Prosthesis-Related Infections / diagnosis
  • Prosthesis-Related Infections / drug therapy
  • Prosthesis-Related Infections / microbiology*
  • Prosthesis-Related Infections / mortality
  • Severity of Illness Index
  • Spain
  • Survival Rate
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents