Risk factors associated with early mortality after recovery from severe listeriosis: a multicentre 17-year longitudinal study

Abstract

Background: Listeriosis presents high rates of mortality but prognostic factors for early prevention are not well established. The aim of this study was to analyse factors associated with in-hospital and early mortality of adults after recovery from severe infection caused by Listeria monocytogenes. Methods: All cases of listeriosis notified in the province of Granada from January 2005 to December 2021, including 9 centres, were included. Only laboratory confirmed non-neonatal cases were considered. Follow-up was conducted by accessing medical records and epidemiological data. Bivariate and multivariate analyses were conducted to detect potential risk factors associated to in-hospital mortality, 1-year, and 5-year early death after recovery. Multivariate Cox regression models were performed. A total of 206 patients were identified. Results: The mean age was 62.6 years (sd, 18.8). A high frequency of comorbidities (88.3%) was observed, and 42 patients (20.4%) died during hospitalisation. Of the patients who recovered from acute infection, 26 (15.9%) died during the following year and 47 (28.7%) died during the following 5 years. The main factors associated with early mortality after recovery were age (HR: 1.03; 95% CI 1.02–1.07), diabetes mellitus (HR 1.86, 95% CI 1.01–3.44), chronic kidney disease (HR 3.96, 95% CI 1.87–8.38), liver disease (HR 3.62, 95% CI 1.64–8.51), and cancer (HR 3.76, 95% CI 1.90–7.46). Conclusion: Listeriosis is associated with high early post-recovery mortality. Our study describes the main prognostic factors, which may help to improve preventive follow-up strategies of adults with severe listeriosis.