Epidemiology and Infection

Gastrointestinal infection

Risk factors for mortality in non-pregnancy-related listeriosis

P. MOOKa1 c1, B. PATELa2 and I. A. GILLESPIEa1a3

a1 Gastrointestinal, Emerging and Zoonotic Infections Department, Health Protection Services Colindale, Health Protection Agency, London, UK

a2 Health Protection Agency Collaborating Laboratory, Department of Microbiology, North West London Hospitals, Harrow, UK

a3 School of Translational Medicine, University of Manchester, Manchester, UK


We examined non-pregnancy-related listeriosis cases in England and Wales reported to the Health Protection Agency between 1990 and 2009 (n=1864) using unconditional multivariate logistic regression analysis to identify factors independently associated with mortality. A subset analysis of cases between 2005 and 2009 (n=694) investigated the additional effect of antibiotic therapy on survival. In these cases particular malignancies, alcoholism, cardiovascular disease, increasing age, and treatment to reduce gastric acid secretion were positively associated with mortality. The absence of a concurrent condition and presence of autoimmune disease had a protective effect. The subset analysis identified illness in winter or spring as a risk factor and antibiotic therapy as a protective factor for mortality. The impact of antibiotic therapy, seasonality and reduced gastric acid status on survival should be further investigated. Policy-makers and clinicians need to more broadly advise those at risk of contracting this disease and dying as a consequence.

(Accepted May 16 2011)

(Online publication June 21 2011)