Clinical characteristics and management of Listeria monocytogenes meningitis in children beyond the neonatal stage: a 10 years retrospective study

The data of Listeria monocytogenes (LM) meningitis in children beyond the neonatal stage has been limited. We aimed to summarize the clinical characteristics, management, and risk factors of neurological complications in LM meningitis children beyond the neonatal stage. We retrospectively reviewed LM meningitis cases from January 2013 to December 2022 at Beijing Children’s Hospital. Clinical characteristics, pathogen detection results and management were analyzed. There were 41 LM meningitis patients at our center, with a median age of 2.3 years (ranging from 6 months to 9 years). Most patients (97.6%) were immunocompetent. Fourteen patients (34.1%) had a history of suspected food contamination. The most common symptom was fever (100%), and 29.2% of patients presented with diarrhea in the early stages of the disease. About 61% of patients showed monocyte predominance in their cerebrospinal fluid (CSF). Thirteen patients (31.7%) experienced neurological complications. Multivariate analysis indicated that a diagnosis delay of more than one week and a CRP level of 50 mg/L or higher were significant risk factors for these neurological complications (p < 0.05). CSF culture rates were much higher before hospital admission (85.7%) compared to after (31.7%, p < 0.05). Metagenomic next-generation sequencing (mNGS) identified pathogens in 3 culture-negative cases. In total, 97.5% of patients received meropenem, either alone or with other antibiotics, and all children recorded a Glasgow Outcome Scale (GOS) score of 5. LM meningitis can affect immunocompetent children. Strengthening food hygiene and safety education is crucial to prevent LM infection. Penicillin or ampicillin are the preferred treatments, while meropenem may be considered as an alternative treatment.