Background: Listeriosis is caused by the facultative anaerobic bacterium Listeria monocytogenes. Infection from Listeria-contaminated food or water is the main etiology. If Listeria travels outside the intestines, it can cause invasive listeriosis, such as sepsis, meningitis, and meningoencephalitis. Invasive illness is especially dangerous for pregnant women and their newborns, elderly people, and people with compromised immune systems or medical conditions such as end-stage kidney disease (ESKD) patients receiving long-term dialysis. Purpose: Describe the manifestations and hospital outcomes of invasive listeriosis and identify the risk factors for in-hospital and one-year mortality in ESKD patients receiving long-term dialysis. Patients and Methods: This retrospective observational study examined hospitalized patient records at a Taiwanese tertiary medical center from August 1, 2000, to August 31, 2021. ESKD patients on chronic dialysis were identified with invasive listeriosis by blood culture and discharge diagnosis. Over 21 years, we accurately recorded 26 cases. Results: ESKD patients on chronic dialysis with invasive listeriosis have a poor prognosis. Only 53.8% of chronic dialysis patients with invasive listeriosis survived their first hospital episode. 42.3% of hospitalized ESKD patients with invasive listeriosis survived one year later. In univariate analysis, shock, tachypnea (RR ≥ 22), respiratory failure, qSOFA score ≥ 2, and lower initial platelet count were linked to greater in-hospital mortality rates. Conclusion: ESKD patients with invasive listeriosis have a grave prognosis. Our research reveals that an early blood sample for a bacterial culture may identify invasive listeriosis in chronic dialysis patients with fever, nausea or vomiting, confusion, and respiratory distress. This study is the first to identify a lower platelet count and qSOFA score ≥ 2 as markers of high-risk invasive listeriosis in ESKD patients.

Listeria monocytogenes causes listeriosis, a serious foodborne illness with a high mortality rate, especially in vulnerable populations. It accounts for 19% of foodborne deaths, with invasive cases having a mortality rate of up to 44%, leading to conditions like meningitis, bacteremia, and meningoencephalitis. However, the prognostic factors remain unclear. This study examines the hospital outcomes of invasive listeriosis and identifies risk factors for in-hospital and one-year mortality. We analyzed the electronic medical records of 118 hospitalized patients with non-perinatal, culture-proven invasive listeriosis collected over a 21-year period. The in-hospital mortality rate was 36.4%, with only 33.1% surviving one year and 22.0% surviving two years. The key findings indicate that a quick Sequential Organ Failure Assessment (qSOFA) score of ≥2 (OR 106.59, p < 0.001), respiratory failure (OR 7.58, p = 0.031), and shorter ampicillin duration (OR 0.53, p = 0.012) independently predicted poorer in-hospital outcomes. Additionally, a qSOFA score of ≥2 (OR 8.46, p < 0.001) and shorter ampicillin duration (OR 0.65, p < 0.001) were linked to higher one-year mortality. This study is the first to identify a qSOFA score of ≥2 as a significant marker for high-risk invasive listeriosis patients, with poorer outcomes linked to a qSOFA score of ≥2, respiratory failure, and shorter ampicillin use.

Background: Invasive aspergillosis (IA) carries high mortality, yet outcomes in patients with concomitant kidney disease are poorly characterized. We examined mortality and pragmatic clinical and mycological markers in hospitalized adults with both conditions. Methods: We retrospectively evaluated 88 adults hospitalized from 2002 to 2020 with proven or probable IA and kidney disease. Renal status was re-adjudicated into four mutually exclusive phenotypes; acute renal replacement therapy (RRT) was recorded separately. qSOFA was assessed at IA diagnosis. Bronchoalveolar lavage (BAL) fungal culture results were available for all 88 patients. In-hospital outcome was defined at discharge, and long-term follow-up was assessed from the index admission. Results: In-hospital mortality was 58.0% (51/88); 25 (28.4%) and 24 (27.3%) patients were documented alive at 1 and 2 years, respectively. Renal phenotypes were maintenance dialysis/end-stage kidney disease requiring long-term dialysis in 24 (27.3%), chronic kidney disease (CKD)CKD without acute kidney injury (AKI) in seven (8.0%), AKI without documented pre-existing CKD in 28 (31.8%), and AKI-on-CKD in 29 (33.0%); 26/64 non-maintenance-dialysis patients (40.6%) received acute RRT. qSOFA ≥ 2 occurred in 98.0% of nonsurvivors versus 40.5% of survivors (p < 0.001). BAL Aspergillus culture was positive in 30/88 (34.1%) and more frequent among nonsurvivors (45.1% vs. 18.9%; p = 0.013). A. fumigatus was the most frequently recorded BAL species (19/30, including mixed cultures). qSOFA ≥ 2 and BAL culture positivity were associated with in-hospital and 2-year mortality in exploratory adjusted analyses. Conclusions: Adults hospitalized with IA and kidney disease had poor outcomes. Acute physiologic severity and BAL Aspergillus culture provided complementary prognostic information, while renal re-phenotyping demonstrated marked host heterogeneity. Contemporary validation is needed.