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Listeria monocytogenes-associated biliary tract infections: a study of 12 consecutive cases and review.

Charlier C, Fevre C, Travier L, Cazenave B, Bracq-Dieye H, Podevin J, Assomany D, Guilbert L, Bossard C, Carpentier F, Cales V, Leclercq A, Lecuit M - Medicine (Baltimore) (2014)

Bottom Line: Gallbladder histological lesions were analyzed in 3 patients and evidenced acute, chronic, or necrotic exacerbation of chronic infection.Genoserogroup of the 12 available strains were IVb (n=6), IIb (n=5), and IIa (n=1).Their survival in the bile was not enhanced when compared with isolates from other listeriosis cases.

View Article: PubMed Central - PubMed

Affiliation: Institut Pasteur, Biology of Infection Unit (CC, CF, LT, ML); Institut Pasteur French National Reference Center and WHO Collaborating Center for Listeria (CC, BC, HBD, AL, ML); Inserm U1117 (CC, CF, LT, ML); Université Paris Descartes, Sorbonne Paris Cité, Centre d'Infectiologie Necker-Pasteur, Hôpital Necker-Enfants Malades, Institut Imagine (CC, ML); Service de Chirurgie viscérale, Centre Hospitalier Universitaire de Nantes (JP); Service de Chirurgie viscérale et digestive, Centre Hospitalier de Roubaix (DA, LG); Service d'Anatomopathologie et Cytologie, Centre Hospitalier Universitaire de Nantes (CB); Service d'Anatomopathologie et Cytologie, Centre Hospitalier de Roubaix (FC); and Service d'Anatomopathologie et Cytologie, Centre Hospitalier de Pau (VC).

ABSTRACT
At present, little is known regarding Listeria monocytogenes-associated biliary tract infection, a rare form of listeriosis.In this article, we will study 12 culture-proven cases reported to the French National Reference Center for Listeria from 1996 to 2013 and review the 8 previously published cases.Twenty cases were studied: 17 cholecystitis, 2 cholangitis, and 1 biliary cyst infection. Half were men with a median age of 69 years (32-85). Comorbidities were present in 80%, including cirrhosis, rheumatoid arthritis, and diabetes. Five patients received immunosuppressive therapy, including corticosteroids and anti-tumor necrosis factor biotherapies. Half were afebrile. Blood cultures were positive in 60% (3/5). Gallbladder histological lesions were analyzed in 3 patients and evidenced acute, chronic, or necrotic exacerbation of chronic infection. Genoserogroup of the 12 available strains were IVb (n=6), IIb (n=5), and IIa (n=1). Their survival in the bile was not enhanced when compared with isolates from other listeriosis cases. Adverse outcome was reported in 33% (5/15): 3 deaths, 1 recurrence; 75% of the patients with adverse outcome received inadequate antimicrobial therapy (P=0.033).Biliary tract listeriosis is a severe infection associated with high mortality in patients not treated with appropriate therapy. This study provides medical relevance to in vitro and animal studies that had shown Listeria monocytogenes ability to survive in bile and induce overt biliary infections.

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Related in: MedlinePlus

Multilocus sequence typing-based minimum spanning tree of 745 Listeriamonocytogenes isolates of lineages I and II. Each circle denotes a single type (ST) and the diameter reflects the number of isolates in that ST. Red sectors denote biliary-tract infections isolates; white sectors correspond to other isolates. Bold lines between circles correspond to links with a single allelic mismatch; plain lines correspond to those with 2 allelic mismatches. Links corresponding to more than 2 allelic mismatches are not represented, as several equally likely alternative links exist; therefore, the relative positions of clonal complexes (CCs) or single STs should not be taken as evidence of phylogenetic proximity. Values inside circles indicate the ST numbers of the central STs of numerically important CCs. Left panel represents lineage I whereas right panel represents lineage II. The arrow denotes 2 isolates from the same patient (Patient 2) who presented with a documented recurrence of infection. All data are available at http://www.pasteur.fr/mlst.
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Figure 1: Multilocus sequence typing-based minimum spanning tree of 745 Listeriamonocytogenes isolates of lineages I and II. Each circle denotes a single type (ST) and the diameter reflects the number of isolates in that ST. Red sectors denote biliary-tract infections isolates; white sectors correspond to other isolates. Bold lines between circles correspond to links with a single allelic mismatch; plain lines correspond to those with 2 allelic mismatches. Links corresponding to more than 2 allelic mismatches are not represented, as several equally likely alternative links exist; therefore, the relative positions of clonal complexes (CCs) or single STs should not be taken as evidence of phylogenetic proximity. Values inside circles indicate the ST numbers of the central STs of numerically important CCs. Left panel represents lineage I whereas right panel represents lineage II. The arrow denotes 2 isolates from the same patient (Patient 2) who presented with a documented recurrence of infection. All data are available at http://www.pasteur.fr/mlst.

Mentions: Th strains were identified as belonging to 9 distinct clonal complexes (CCs), without any CC associated with biliary tract strains (Figure 1).


Listeria monocytogenes-associated biliary tract infections: a study of 12 consecutive cases and review.

Charlier C, Fevre C, Travier L, Cazenave B, Bracq-Dieye H, Podevin J, Assomany D, Guilbert L, Bossard C, Carpentier F, Cales V, Leclercq A, Lecuit M - Medicine (Baltimore) (2014)

Multilocus sequence typing-based minimum spanning tree of 745 Listeriamonocytogenes isolates of lineages I and II. Each circle denotes a single type (ST) and the diameter reflects the number of isolates in that ST. Red sectors denote biliary-tract infections isolates; white sectors correspond to other isolates. Bold lines between circles correspond to links with a single allelic mismatch; plain lines correspond to those with 2 allelic mismatches. Links corresponding to more than 2 allelic mismatches are not represented, as several equally likely alternative links exist; therefore, the relative positions of clonal complexes (CCs) or single STs should not be taken as evidence of phylogenetic proximity. Values inside circles indicate the ST numbers of the central STs of numerically important CCs. Left panel represents lineage I whereas right panel represents lineage II. The arrow denotes 2 isolates from the same patient (Patient 2) who presented with a documented recurrence of infection. All data are available at http://www.pasteur.fr/mlst.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4616294&req=5

Figure 1: Multilocus sequence typing-based minimum spanning tree of 745 Listeriamonocytogenes isolates of lineages I and II. Each circle denotes a single type (ST) and the diameter reflects the number of isolates in that ST. Red sectors denote biliary-tract infections isolates; white sectors correspond to other isolates. Bold lines between circles correspond to links with a single allelic mismatch; plain lines correspond to those with 2 allelic mismatches. Links corresponding to more than 2 allelic mismatches are not represented, as several equally likely alternative links exist; therefore, the relative positions of clonal complexes (CCs) or single STs should not be taken as evidence of phylogenetic proximity. Values inside circles indicate the ST numbers of the central STs of numerically important CCs. Left panel represents lineage I whereas right panel represents lineage II. The arrow denotes 2 isolates from the same patient (Patient 2) who presented with a documented recurrence of infection. All data are available at http://www.pasteur.fr/mlst.
Mentions: Th strains were identified as belonging to 9 distinct clonal complexes (CCs), without any CC associated with biliary tract strains (Figure 1).

Bottom Line: Gallbladder histological lesions were analyzed in 3 patients and evidenced acute, chronic, or necrotic exacerbation of chronic infection.Genoserogroup of the 12 available strains were IVb (n=6), IIb (n=5), and IIa (n=1).Their survival in the bile was not enhanced when compared with isolates from other listeriosis cases.

View Article: PubMed Central - PubMed

Affiliation: Institut Pasteur, Biology of Infection Unit (CC, CF, LT, ML); Institut Pasteur French National Reference Center and WHO Collaborating Center for Listeria (CC, BC, HBD, AL, ML); Inserm U1117 (CC, CF, LT, ML); Université Paris Descartes, Sorbonne Paris Cité, Centre d'Infectiologie Necker-Pasteur, Hôpital Necker-Enfants Malades, Institut Imagine (CC, ML); Service de Chirurgie viscérale, Centre Hospitalier Universitaire de Nantes (JP); Service de Chirurgie viscérale et digestive, Centre Hospitalier de Roubaix (DA, LG); Service d'Anatomopathologie et Cytologie, Centre Hospitalier Universitaire de Nantes (CB); Service d'Anatomopathologie et Cytologie, Centre Hospitalier de Roubaix (FC); and Service d'Anatomopathologie et Cytologie, Centre Hospitalier de Pau (VC).

ABSTRACT
At present, little is known regarding Listeria monocytogenes-associated biliary tract infection, a rare form of listeriosis.In this article, we will study 12 culture-proven cases reported to the French National Reference Center for Listeria from 1996 to 2013 and review the 8 previously published cases.Twenty cases were studied: 17 cholecystitis, 2 cholangitis, and 1 biliary cyst infection. Half were men with a median age of 69 years (32-85). Comorbidities were present in 80%, including cirrhosis, rheumatoid arthritis, and diabetes. Five patients received immunosuppressive therapy, including corticosteroids and anti-tumor necrosis factor biotherapies. Half were afebrile. Blood cultures were positive in 60% (3/5). Gallbladder histological lesions were analyzed in 3 patients and evidenced acute, chronic, or necrotic exacerbation of chronic infection. Genoserogroup of the 12 available strains were IVb (n=6), IIb (n=5), and IIa (n=1). Their survival in the bile was not enhanced when compared with isolates from other listeriosis cases. Adverse outcome was reported in 33% (5/15): 3 deaths, 1 recurrence; 75% of the patients with adverse outcome received inadequate antimicrobial therapy (P=0.033).Biliary tract listeriosis is a severe infection associated with high mortality in patients not treated with appropriate therapy. This study provides medical relevance to in vitro and animal studies that had shown Listeria monocytogenes ability to survive in bile and induce overt biliary infections.

Show MeSH
Related in: MedlinePlus