Abstract
Background: The characteristics of listeriosis in children beyond the neonatal period are unknown.
Methods: MONALISA is a prospective cohort study of listeriosis in France. All children aged 1 month to 18 years with microbiologically confirmed infection were enrolled.
Findings: We included 48 children among the 1,646 MONALISA patients (3%): 29/48 (60%) with neurolisteriosis, 12/48 (25%) with bacteremia, 6/48 (13%) with abdominal infection (gastroenteritis [n = 4] and appendicitis [n = 2]), and 1 with skin abscess. The median age was 4 years (interquartile range [IQR]: 25-75, range: 1-10), 23 were male (23/48, 48%), and 16 (16/48, 33%) reported at least one past medical event: 8/12 (67%) of those with bacteremia but only 8/29 (28%) of those with neurolisteriosis (p = 0.034) and none of the seven children with other forms. Diarrhea was reported in 21/48 children (44%) and was equally distributed among the different forms. Neurolisteriosis presented as meningoencephalitis (13/29, 45%) or isolated meningitis (16/29, 55%). Twenty-three children with neurolisteriosis presented without known immunosuppression (23/29, 79%), including 20 of the 22 children younger than 5 years (90%). Fourteen patients (14/48, 29%) required intensive care unit management. There were four in-hospital deaths (4/48, 8%), two attributed to listeriosis. All surviving children with neurolisteriosis recovered without permanent disability.
Conclusion: Listeriosis in children has specificities: neurolisteriosis in younger children most often occurs in the absence of immunosuppression and often presents as isolated meningitis, abdominal forms are more common than in adults, and the outcome is much better than in adults.
Funding: This work was funded by Institut Pasteur, INSERM, Santé Publique France, and Program Hospitalier de Recherche Clinique.