BAĞIŞIKLIĞI BASKILANMIŞ, PERİTONEAL KARSİNOMATOZİSLİ BİR HASTADA LISTERIA MONOCYTOGENES’E BAĞLI SEPSİS: OLGU SUNUMU

Yıl 2023, Cilt: 86 Sayı: 2, 176 - 179, 30.03.2023

İrem Unat , Kemal Tekin , Mehmet Ozan Durmaz , Musa Barış Aykan , Tuğrul Hoşbul

https://doi.org/10.26650/IUITFD.1208626

Öz

Listeria monocytogenes, immünokompetan bireylerde genellikle kontamine olmuş gıdaların tüketilmesi ile kendi kendini sınırlayan gastroenterit tablosuna, immun sistemi baskılanmış bireylerde ve yenidoğanda ise ölümcül enfeksiyonlara yol açabilen fırsatçı bir enfeksiyöz ajandır. Karın içi tümörlerin lokal etkileri, immün yanıtın baskılanması, peritoneal membran ve gastrointestinal sistemin bütünlüğünü bozan operasyonlar patojen kaynaklı invaziv enfeksiyon riskinde artışa neden olabilir. Abdominal ve pelvik maligniteleri olan hastaların tedavisinde uygulanan sitoredüktif cerrahi girişimler, sistemik ve/veya hipertermik intraperitoneal kemoterapi (HİPEK) hastalıksız sağkalımı arttırmakla birlikte gastrointestinal ve sistemik komplikasyonlar yoluyla L. monocytogenes’in neden olduğu enfeksiyonlara zemin hazırlayabilir. Bu olgu sunumunda, sistemik kemoterapi ve sitoredüktif cerrahi ile kombine HİPEK tedavileri sonrası L. monocytogenes’e bağlı sepsis tanısı alan 71 yaşında bir erkek hasta tartışılmış ve L. monocytogenes’in kanser, cerrahi işlem ve kematerapötik ajanların kullanımı gibi sebeplerle immün sistemi baskılanmış bireylerde sistemik ve hayatı tehdit edici enfeksiyonlara neden olabileceği konusunda klinik ve laboratuvar farkındalığı yaratmak amaçlanmıştır.

Anahtar Kelimeler

Hipertermik intraperitoneal kemoterapi, Listeria monocytogenes, peritoneal karsinomatozis, sistemik kemoterapi, sepsis

SEPSIS DUE TO LISTERIA MONOCYTOGENES IN AN IMMUNOCOMPROMISED PATIENT WITH PERITONEAL CARCINOMATOSIS: A CASE REPORT

Öz

Listeria monocytogenes is an opportunistic infectious agent that can cause self-limiting gastroenteritis in immunocompetent individuals, usually with the consumption of contaminated foods, and fatal infections in immunocompromised individuals and newborns. Local effects of intra-abdominal tumors, immune response suppression, and operations that disrupt the integrity of the peritoneal membrane and gastrointestinal tract may increase the risk of pathogen-induced invasive infection. Although cytoreductive surgical interventions, systemic and/or hyperthermic intraperitoneal chemotherapy (HIPEC) applied in the treatment of patients with abdominal and pelvic malignancies increase disease-free survival, they may predispose to infections caused by L. monocytogenes through gastrointestinal and systemic complications. In this case report, a 71-year-old male patient diagnosed with sepsis due to L. monocytogenes after treatments with systemic chemotherapy and cytoreductive surgery combined with HIPEC is discussed. It is aimed to raise clinical and laboratory awareness that L. monocytogenes may cause systemic and life-threatening infections in individuals whose immune system is suppressed due to cancer, surgical procedures, and the use of chemotherapeutic agents.

Anahtar Kelimeler

Hyperthermic intraperitoneal chemotherapy, Listeria monocytogenes, peritoneal carcinomatosis, systemic chemotherapy, sepsis

Kaynakça

• 1. Lorber B. Listeria monocytogenes. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and Practice of Infectious Diseases. Philadelphia: Churchill Livingstone; 2010.p.2707-14. [CrossRef] google scholar
• 2. Hayes PS, Graves LM, Swaminathan B, Ajello GW, Malcolm GB, Weaver RE, et al. Comparison of Three Selective Enrichment Methods for the Isolation of Listeria monocytogenes from Naturally Contaminated Foods. J Food Prot 1992;55(12):952-9. [CrossRef] google scholar
• 3. Schlech WF 3rd. Foodborne listeriosis. Clin Infect Dis 2000;31(3):770-5. [CrossRef] google scholar
• 4. Schlech WF. Epidemiology and Clinical Manifestations of Listeria monocytogenes Infection. Microbiol Spectr 2019;7(3):GPP3-0014-2018. [CrossRef] google scholar
• 5. Borucki MK, Call DR. Listeria monocytogenes serotype identification by PCR. J Clin Microbiol 2003;41(12):5537-40. [CrossRef] google scholar
• 6. Luque-Sastre L, Arroyo C, Fox EM, McMahon BJ, Bai L, Li F, et al. Antimicrobial Resistance in Listeria Species. Microbiol Spectr 2018;6(4):ARBA-0031-2017. [CrossRef] google scholar
• 7. Disson O, Moura A, Lecuit M. Making Sense of the Biodiversity and Virulence of Listeria monocytogenes. Trends Microbiol 2021;29(9):811-22. [CrossRef] google scholar
• 8. Goodman MD, McPartland S, Detelich D, Saif MW. Chemotherapy for intraperitoneal use: a review of hyperthermic intraperitoneal chemotherapy and early postoperative intraperitoneal chemotherapy. J Gastrointest Oncol 2016;7(1):45-57. google scholar
• 9. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 12.0, 2022. http://www.eucast.org. google scholar
• 10. Gahan CG, Hill C. Listeria monocytogenes: survival and adaptation in the gastrointestinal tract. Front Cell Infect Microbiol 2014;4(9):1-7. [CrossRef] google scholar
• 11. Kulesh R, Shinde SV, Khan WA, Chaudhari SP, Patil AR, Kurkure VN, et al. The occurrence of Listeria monocytogenes in goats, farm environment and invertebrates. Biol Rhytm Res 2019;53(6):831-40. [CrossRef] google scholar
• 12. Sleator RD, Watson D, Hill C, Gahan CGM. The interaction between Listeria monocytogenes and the host gastrointestinal tract. Microbiology (Reading) 2009;155(Pt8):2463-75. [CrossRef] google scholar
• 13. Barbuddhe SB, Chakraborty T. Listeria as an enteroinvasive gastrointestinal pathogen. Curr Top Microbiol Immunol 2009;337(1):173-95. [CrossRef] google scholar
• 14. Nguyen BN, Peterson BN, Portnoy DA. Listeriolysin O: A phagosome-specific cytolysin revisited. Cell Microbiol 2019; 21(3):e12988. [CrossRef] google scholar
• 15. Itoga M, Asari Y, Morimoto T, Taima K, Nakamura K, Tanaka Y, et al. Sepsis caused by Listeria monocytogenes during chemotherapy for small cell carcinoma of the thymus. BMC Res Notes 2015;8(1):268. [CrossRef] google scholar
• 16. Berg RD, Garlington AW. Translocation of certain indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other organs in a gnotobiotic mouse model. Infect Immun 1979;23(2):403-11. [CrossRef] google scholar
• 17. Smibert OC, Slavin MA, Teh B, Heriot AG, Penno J, Ismail H, et al. Epidemiology and risks for infection following cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy. Support Care Cancer 2020;28(6):2745-52. [CrossRef] google scholar
• 18. European Food Safety Authority and European Centre for Disease Prevention and Control. The European Union One Health 2021 Zoonoses Report. EFSA Journal 2022;20(12):7666-273. [CrossRef] google scholar
• 19. Şahin S, Moğulkoç MN, Kalın R. Prevalence and Serotype Distribution of Listeria monocytogenes Isolated from Retail Raw Meats. Erciyes Üniv Vet Fak Derg 2020;17(1):22-7. google scholar
• 20. Doganay M. Listeriosis: clinical presentation. FEMS Immunol Med Microbiol 2003;35(3):173-5. [CrossRef] google scholar
• 21. Aktaş Z, Akman A, Bal Ç. Listeria monocytogenes’e bağlı sepsis: bir olgu sunumu. İnfeksiyon Derg 2005;19(4):471-5. google scholar
• 22. Ağuş N, Yılmaz N, Medeni ŞS, Kuzucu L, Akgüre N. Listeria monocytogenes’e bağlı sepsis: Bir olgu sunumu. ANKEM Derg 2013;27(2):80-2. [CrossRef] google scholar
• 23. Yıldız O, Aygen B, Esel D, Kayabaş U, Alp E, Sümerkan B, et al. Sepsis and meningitis due to Listeria monocytogenes. Yonsei Med J 2007;48(3):433-9. [CrossRef] google scholar