Edith Laurent

Incidence of Listeriosis and Related Mortality Among Groups at Risk of Acquiring Listeriosis

BACKGROUND Listeriosis is a foodborne disease of significant public health concern that primarily affects persons with recognized underlying conditions or diseases that impair cell-mediated immunity. The degree of risk posed by the different underlying conditions is crucial to prioritize prevention programs that target the highest risk populations. METHODS We reviewed cases of listeriosis reported in France from 2001 to 2008. Numbers of cases and deaths were tabulated by age and underlying condition. Measures of the impact of specific underlying conditions on the occurrence of listeriosis were calculated. For estimating the total number of persons living with specific diseases, we applied prevalence estimates of these diseases to the French population. Underlying conditions were ranked by the degree to which they increased the risk of listeriosis. RESULTS From 2001 to 2008, 1959 cases of listeriosis were reported in France (mean annual incidence 0.39 per 100,000 residents). Compared with persons <65 years with no underlying conditions, those with chronic lymphocytic leukemia had a >1000-fold increased risk of acquiring listeriosis, and those with liver cancer; myeoloproliferative disorder; multiple myeloma; acute leukemia; giant cell arteritis; dialysis; esophageal, stomach, pancreas, lung, and brain cancer; cirrhosis; organ transplantation; and pregnancy had a 100-1000-fold increased risk of listeriosis. CONCLUSIONS To be effective and acceptable to physicians and patients, listeriosis prevention strategies should be targeted based on evidence of increased risk. Stringent dietary guidance, to avoid specific foods with a high risk for Listeria contamination, should be targeted to pregnant women and to others at highest risk of listeriosis.

Increase of Neisseria gonorrhoeae ciprofloxacin resistance in France in 2001-2003.

AFTER THE SPREAD OF PENICILLINand tetracycline-resistant strains in the early 1990s, ciprofloxacin has been widely used as first-line therapy for gonorrhea. Recently, some European countries have reported an increase of Neisseria gonorrhoeae (NG) ciprofloxacin resistance.1–3 In the United States, fluoroquinolones are no longer recommended for gonorrhea acquired in Hawaii and in California, but also for gonococcal infections occurring in male patients who have sex with men.4 In France, NG antimicrobial susceptibility has been monitored through a sentinel laboratory network, RENAGO, since 1986. An average of 230 laboratories (82% private and 18% laboratories attached to a hospital) located in all regions of France (except Corsica) participate each year. NG ciprofloxacin resistance, which was low until 2000,5 has recently sharply increased.

Real-Time Whole-Genome Sequencing for Surveillance of Listeria monocytogenes, France.

During 2015–2016, we evaluated the performance of whole-genome sequencing (WGS) as a routine typing tool. Its added value for microbiological and epidemiologic surveillance of listeriosis was compared with that for pulsed-field gel electrophoresis (PFGE), the current standard method. A total of 2,743 Listeria monocytogenes isolates collected as part of routine surveillance were characterized in parallel by PFGE and core genome multilocus sequence typing (cgMLST) extracted from WGS. We investigated PFGE and cgMLST clusters containing human isolates. Discrimination of isolates was significantly higher by cgMLST than by PFGE (p<0.001). cgMLST discriminated unrelated isolates that shared identical PFGE profiles and phylogenetically closely related isolates with distinct PFGE profiles. This procedure also refined epidemiologic investigations to include only phylogenetically closely related isolates, improved source identification, and facilitated epidemiologic investigations, enabling identification of more outbreaks at earlier stages. WGS-based typing should replace PFGE as the primary typing method for L. monocytogenes.

Pregnancy-related listeriosis in France, 1984 to 2011, with a focus on 606 cases from 1999 to 2011.

This study describes trends in the incidence of pregnancy-related listeriosis in France between 1984 and 2011, and presents the major characteristics of 606 cases reported between 1999 and 2011 to the French Institute for Public Health Surveillance through the mandatory notification system. The incidence of pregnancy-related listeriosis decreased by a factor of 12 from 1984 to 2011. This reduction was a result of progressive implementation of specific Listeria monocytogenes control measures in food production. A lower incidence of pregnancy-related listeriosis was observed in regions with a lower prevalence of toxoplasmosis. Given that dietary recommendations in pregnancy target both toxoplasmosis and listeriosis prevention, we suppose that recommendations may have been delivered and followed more frequently in these regions. Cases reported between 1999 and 2011 (n=606) were classified as maternal infections with ongoing pregnancy (n=89, 15%), fetal loss (n=166, 27%), or live-born neonatal listeriosis (n=351, 58%). The majority of live-born neonatal listeriosis cases (n=216, 64%) were preterm births (22–36 weeks of gestation), of whom 14% (n=30) were extremely preterm births (22–27 weeks of gestation). Eighty per cent of mothers reported having eaten high risk food during pregnancy. A better awareness of dietary recommendations in pregnant women is therefore necessary.

Seize années de surveillance des infections invasives bactériennes en France (1991-2006) à travers le réseau EPIBAC

Resume Afin de surveiller les principales infections invasives bacteriennes d’origine communautaire en France, les biologistes hospitaliers volontaires du reseau Epibac notifient a l’InVS les cas de bacteriemies et de meningites a Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, Streptococcus agalactiae et Streptococcus pyogenes. Disposant aujourd’hui de plus de quinze annees de recueil de donnees validees, avec une couverture nationale des admissions hospitalieres proche en 2006 de 80 % et une exhaustivite de recueil egalement autour de 80 %, la base de donnees Epibac permet d’analyser les tendances et plus particulierement l’impact de mesures de prevention, notamment vaccinales, relatives aux pathogenes etudies. Les analyses mettent en evidence l’impact de la vaccination anti-H. influenzae de type b a travers une chute tres rapide de l’incidence des infections invasives dues a H. influenzae au debut des annees 1990, la diminution de l’incidence des infections invasives a L. monocytogenes suite aux mesures de controle adoptees en 1992 et l’inversion recente de cette tendance, l’impact de la vaccination pneumococcique recemment generalisee sur l’incidence des infections invasives a S. pneumoniae chez le jeune enfant et la reduction du nombre d’infections invasives precoces a S. agalactiae suite a l’adoption de mesures preventives pendant la grossesse. La comparabilite des resultats avec ceux generes par d’autres systemes de surveillance, lorsqu’ils existent, conforte la validite d’Epibac et des analyses effectuees a partir de ces donnees. Ce reseau volontaire constitue une source unique de surveillance des infections invasives bacteriennes ne faisant pas l’objet d’une declaration obligatoire.

Listériose humaine: Une zoonose d’origine alimentaire

SUMMARY Human listeriosis: a foodborne zoonotic disease Human listeriosis is an uncommon foodborne bacterial illness caused by ingestion of food contaminated by Listeria monocytogenes. This bacterium is widespread in nature and is a common cause of zoonosis in herd animals. Many food products might become contaminated at various stages of production. Although ingestion of L. monocytogenes is a frequent occurrence, incidence of human listeriosis in the French general population is low — approximately 5 cases per million population — but incidence rates are higher in particular at-risk groups including older adults, pregnant women and their newborns, and persons with impaired cell-immunity. Invasive clinical syndromes most frequently include bacteremia, central nervous system infection and pregnancy-related infection. Other rare invasive presentations include joint and bone infections, endocarditis, as well as foreign material-associated infections. Non-invasive illnesses are rare and include acute febrile gastroenteritis and localized cutaneous or ocular infections. Invasive listeriosis is a potential severe condition with a case fatality rate of 20-30%. Incidence of human listeriosis has dramatically declined over the past decades, primarily because of implementation of food safety measures in the food industry. By carefully following food safety precautions, risk of listeriosis can be substantially reduced. Listeria monocytogenes – zoonosis – surveillance – foodborne outbreakes. 1. Caracteristiques microbiologiques Le genre Listeria comporte dix especes : L. monocytogenes, L. innocua, L. ivanovii subsp. ivanovii et subsp. londoniensis, L. seeligeri, L. welshimeri, L. grayi biovar grayi et biovar murrayi,