Neonatal listeriosis during a countrywide epidemic in South Africa : a tertiary hospital’s experience

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dc.contributor.authorDramowski, Angelaen_ZA
dc.contributor.authorLloyd, L. G.en_ZA
dc.contributor.authorBekker, A.en_ZA
dc.contributor.authorHolgate, S.en_ZA
dc.contributor.authorAucamp, M.en_ZA
dc.contributor.authorReddy, K.en_ZA
dc.contributor.authorFinlayson, H.en_ZA
dc.date.accessioned2019-11-21T12:01:19Z
dc.date.available2019-11-21T12:01:19Z
dc.date.issued2018
dc.descriptionCITATION: Dramowski, A. et al. 2018. Neonatal listeriosis during a countrywide epidemic in South Africa : a tertiary hospital’s experience. South African Medical Journal, 108(10):818-827, doi:10.7196/SAMJ.2018.v108i10.13207.
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground. A countrywide epidemic of Listeria monocytogenes (LM) in South Africa began in the first quarter of 2017, rapidly becoming the world’s largest LM outbreak to date. Methods. We describe the clinical course of neonates with culture-confirmed LM infection admitted to a tertiary neonatal unit at Tygerberg Hospital, Cape Town (1 January 2017 - 31 January 2018). Current epidemic LM cases were compared with a historical cohort of sporadic neonatal LM cases at our institution (2006 - 2016). The global literature on epidemic neonatal LM outbreaks (1 January 1978 - 31 December 2017) was reviewed. Results. Twelve neonates (median gestational age 35 weeks, median birth weight 2 020 g) were treated for confirmed LM bacteraemia in 2017/18, presenting at a median age of 0.5 days. In 5 cases, neurolisteriosis was suspected. Three neonates died (25.0%) v. 8/13 neonatal deaths (61.6%) in the sporadic listeriosis cohort (2006 - 2016) (p=0.075). The institution’s neonatal LM infection incidence increased significantly in 2017 from a historical rate of 0.17/1 000 live births to 1.4/1 000 (p<0.001). During the current LM epidemic, the crude neonatal fatality rate exceeded the average calculated global epidemic neonatal LM mortality (3/12 (25.0%) v. 50/290 (17.2%); p=0.448). Possible factors contributing to the high mortality rate in this epidemic LM neonatal cohort may include more virulent disease associated with sequence type 6 and the predominance of early-onset disease. Conclusions. Epidemic neonatal listeriosis at Tygerberg Hospital was associated with a predominance of bacteraemic, early-onset disease. Listeriosis-associated mortality rates were higher than previously published, but lower than the rate in a historical institutional cohort.en_ZA
dc.description.sponsorshipNational Research Foundation rated researcher incentive fund
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/12437
dc.description.versionPublisher's version
dc.format.extent10 pages
dc.identifier.citationDramowski, A. et al. 2018. Neonatal listeriosis during a countrywide epidemic in South Africa : a tertiary hospital’s experience. South African Medical Journal, 108(10):818-827, doi:10.7196/SAMJ.2018.v108i10.13207.
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.2018.v108i10.13207
dc.identifier.urihttp://hdl.handle.net/10019.1/106863
dc.language.isoen_ZAen_ZA
dc.publisherHealth & Medical Publishing Group
dc.rights.holderAuthors retain copyright
dc.subjectListeria monocytogenesen_ZA
dc.subjectNewborn infantsen_ZA
dc.subjectNewborn infants -- Diseasesen_ZA
dc.subjectListeriosisen_ZA
dc.titleNeonatal listeriosis during a countrywide epidemic in South Africa : a tertiary hospital’s experienceen_ZA
dc.typeArticleen_ZA
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