Clinical features and antibiotic treatment of early-onset neonatal listeriosis

Objective To analyze the clinical features, efficacy of antibiotic treatment, and outcome of neonatal listeriosis. Methods This was a retrospective study that included all neonates diagnosed with listeriosis between January 2010 and December 2021. Results Nine male patients and five female patients were analyzed, including 11 preterm and 3 term infants. The mean gestational age was 34 +/- 2.6 weeks (29 + 2-40 + 2 weeks), and the mean birth weight was 2392 +/- 603 g (1370-3580 g). The maternal clinical manifestations included fever (13/14 [92.9%]), meconium-stained amniotic fluid (12/14 [85.7%]), and intrauterine fetal distress (11/14 [78.6%]). The neonates presented with fever (14/14 [100%]), generalized maculopapular rash (7/14 [50%]), and convulsions (8/14 [57.1%]). Laboratory tests showed leukocytosis (11/14 [78.6%]), monocytosis (9/14 [64.3%]), elevated C-reactive protein levels (13/14 [92.9%]), and thrombocytopenia (6/14 [42.9%]). Eight patients had central nervous system involvement, and Listeria monocytogenes was isolated from the blood in all cases. Empiric antibiotic therapy consisted of a combination of third-generation cephalosporins and penicillin or vancomycin. Four patients died, and 10 patients were cured. Conclusions Preterm infants were more susceptible to listeria infection than term infants, with most having multiple organ injuries. Combined antibiotic application improved the effectiveness of treatment.