Gentamicin combination treatment is associated with lower mortality in patients with invasive listeriosis: a retrospective analysis Original paper
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Microbes
Microbes
Microbes are microscopic organisms living in and on the human body, shaping health through digestion, vitamin production, and immune protection. When microbial balance is disrupted, disease can occur. This guide explains key microbe types—bacteria, viruses, fungi, protozoa, and archaea—plus major pathogenic and beneficial examples.
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What was studied?
This study examined the effects of gentamicin combination therapy on 90-day mortality in patients with invasive listeriosis, comparing it to monotherapy using ampicillin or other antibiotics. It was a retrospective, single-center study conducted at the University Medical Center Hamburg-Eppendorf, which analyzed patient data collected between 2009 and 2020.
Who was studied?
The study focused on patients diagnosed with invasive listeriosis, specifically those with Listeria monocytogenes bacteraemia or neurolisteriosis. A total of 36 patients were included, with 21 receiving gentamicin combination therapy and 15 receiving monotherapy.
What were the most important findings?
The key finding of this study was that patients receiving gentamicin combination therapy had significantly lower 90-day mortality (10%) compared to those receiving monotherapy (60%). The study also highlighted that patients with neurolisteriosis were more likely to receive gentamicin combination therapy, which may have contributed to the lower mortality observed in this group. Additionally, the study found no significant differences in baseline kidney function or other comorbidities that would contraindicate gentamicin use, suggesting that the reduced mortality could be attributed to the therapy itself rather than differences in patient conditions. Multivariable Cox regression analysis indicated that the gentamicin combination treatment had a significantly reduced hazard ratio (0.06) for 90-day mortality, pointing to its effectiveness in improving survival rates.
What are the greatest implications of this study?
The findings of this study strongly suggest that gentamicin combination therapy improves survival rates for patients with invasive listeriosis, which could influence clinical practice by promoting more widespread use of this treatment in real-world settings. The study also raises concerns about the adequacy of current antibiotic practices, as a significant proportion of patients in the monotherapy group did not receive the recommended combination treatment. These results may lead to changes in treatment protocols, emphasizing the need for more aggressive management of invasive listeriosis to reduce mortality, particularly in patients with neurolisteriosis or those with significant comorbidities.
Listeria monocytogenes
Listeria monocytogenes is an opportunistic pathogen capable of surviving in diverse environments, including soil, water, and decaying vegetation. L. monocytogenes has the unique ability to evade the immune system by moving directly from cell to cell within the host. This intracellular lifestyle allows the bacterium to avoid extracellular immune detection, contributing to its ability to cause invasive diseases like meningitis and septicemia, particularly in the elderly and immunocompromised.