Listeriosis in renal transplant recipients: report of an outbreak and review of 102 cases

We observed six renal transplant recipients with listeriosis during a 10-week period in the autumn of 1979. Investigation of this outbreak established that the first four cases wer close contacts, all infected by Listeria monocytogenes serotype 1b. The source of infection and route of spread were no...

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Bibliographic Details
Published inReviews of infectious diseases Vol. 4; no. 3; p. 665
Main Authors Stamm, A M, Dismukes, W E, Simmons, B P, Cobbs, C G, Elliott, A, Budrich, P, Harmon, J
Format Journal Article
LanguageEnglish
Published United States 01.05.1982
Subjects
Adult
Disease Outbreaks
Encephalitis - complications
Female
Humans
Kidney Transplantation
Listeriosis - complications
Listeriosis - diagnosis
Listeriosis - drug therapy
Male
Meningitis - complications
Middle Aged
Pneumonia - complications
Postoperative Complications
Sepsis - complications
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Summary:We observed six renal transplant recipients with listeriosis during a 10-week period in the autumn of 1979. Investigation of this outbreak established that the first four cases wer close contacts, all infected by Listeria monocytogenes serotype 1b. The source of infection and route of spread were not identified. A total of 102 renal transplant recipients with listeriosis have now been reported. The major manifestation of disease was meningitis in 50% of the patients, parenchymal disease of the central nervous system in 10%, both meningitis and parenchymal disease of the central nervous system in 9%, and primary bacteremia in 30%. The overall mortality rate was 26%. Pneumonia due to L. monocytogenes, a previously neglected finding, was present in seven patients (7%); five of the seven died. The route of transmission may sometimes be respiratory. Special techniques for isolation of L. monocytogenes from sputum are usually required but not complicated. We recommend that individual renal transplant patients with listeriosis be cared for with secretion and excretion precautions and that they be treated with ampicillin and gentamicin. We advocate the serotyping of all isolates and a careful case-control analysis of all epidemics, but we do not support the use of serologic testing or surveillance cultures.
ISSN:0162-0886