Journal Article

Risk Factors for Mortality among Patients with Nonperinatal Listeriosis in Los Angeles County, 1992–2004

Ramon E. Guevara, Laurene Mascola and Frank Sorvillo

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 48, issue 11, pages 1507-1515
Published in print June 2009 | ISSN: 1058-4838
Published online June 2009 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/598935
Risk Factors for Mortality among Patients with Nonperinatal Listeriosis in Los Angeles County, 1992–2004

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Background. Listeriosis is a relatively rare foodborne disease with significant public health implications. The causative pathogen, Listeria monocytogenes, grows well in refrigeration, is associated with a case-fatality rate of 20%, and causes an estimated 28% of all foodborne disease-related deaths. Nevertheless, data on the risk factors for listeriosis mortality are limited.

Methods. Using the passive surveillance listeriosis database of the County of Los Angeles Department of Public Health, we conducted a 13-year retrospective cohort study to describe nonperinatal listeriosis mortality in Los Angeles County during the period 1992–2004. A nonperinatal listeriosis case was defined as one occurring in a nonpregnant person >42 days of age who resided in Los Angeles County and had a culture positive for L. monocytogenes.

Results. Unconditional multivariable logistic regression analysis of 281 nonperinatal listeriosis cases with 29 main effects variables resulted in finding nonhematological malignancy (odds ratio [OR], 5.92; 95% confidence interval [CI], 1.85–18.9), alcoholism (OR, 4.63; 95% CI, 1.36–15.8), age ⩾70 years (OR, 3.44; 95% CI, 1.50–7.87), steroid medication (OR, 3.34; 95% CI, 1.38–8.08), and kidney disease (OR, 2.94; 95% CI, 1.18–7.31) to be statistically significant risk factors for mortality. Other listeriosis mortality risk factors with adjusted odds ratios >1.5 included blood transfusion, asthma, black race, Asian race, use of antibiotics, hypertension, receipt of chemotherapy, and Hispanic race. Patients admitted to the hospital with a diagnosis of sepsis alone had the highest mortality (23.7%), whereas patients with cases of meningitis alone had the lowest mortality (3.13%).

Conclusions. The findings of this study should be used to help researchers and clinicians focus on specific risk factors to prevent nonperinatal listeriosis-related deaths.

Journal Article.  4662 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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