Neurolisteriosis in the Samara Region

Relevance. Listeriosis is an urgent public health problem, as it can affect the central nervous system with listeriosis meningitis and meningoencephalitis development. The disease is characterized by high mortality, which is especially dangerous for immunocompromised populations. It spreads mainly through food products, which causes serious risks to public health, and considering the food industry globalization, the listeriosis spread problem is becoming international.

The aim of the study: is to determine the listeriosis meningoencephalitis clinic, diagnostics and treatment features at the present stage.

Material and methods. The work was carried out on the basis of the clinic and the department of infectious diseases with epidemiology of the Samara State Medical University. From June 2023 to March 2025, 137 patients with meningitis diagnosis were treated. Clinical, laboratory, epidemiological, and statistical analysis were conducted.

Results. Of the 137 patients diagnosed with meningitis, 90 had serous meningitis and 47 had purulent meningitis. In a third of the cases, the diagnosis was not etiologically confirmed. In seven cases, listeriosis meningitis was identified, and the diagnosis was confirmed by the Listeria monocytogenes detection in the cultures. The clinical manifestations, changes in peripheral blood and cerebrospinal fluid features, etiotropic treatment choice have been determined.

Conclusion. The neurolisteriosis proportion among other etiologies meningitis remains high and tends to increase in immunocompromised patients. The neurolisteriosis clinical picture is not specific. In patients with neurolisteriosis, the cerebrospinal fluid general and biochemical parameters do not correspond to each other: 2-3-digit pleocytosis was detected in combination with elevated protein and lactate levels, accompanied by a pronounced decrease in cerebrospinal fluid glucose. Gram-positive rods detection by cerebrospinal fluid microscopy, taking into account the cerebrospinal fluid examination results, makes it possible to suspect neurolisteriosis and timely prescribe appropriate antibacterial therapy. It is advisable to perform cerebrospinal fluid PCR for DNA Listeria monocytogenes in immunosuppressed patients during the meningitis diagnosis and differential diagnosis. In the neurolisteriosis case, an effective treatment regimen includes the carbapenems and aminoglycosides use. Alternative treatment regimens include penicillins, co-trimoxazole, linezolid and levofloxacin.

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