Global burden of Listeria monocytogenes meningitis in children, 1990–2021: an analysis from the Global Burden of Disease Study 2021

Introduction

Listeria monocytogenes (L. monocytogenes) is a Gram-positive facultative intracellular coccobacillus and an opportunistic pathogen that can cause human listeriosis (1). It is ubiquitous in natural environments and frequently contaminates a wide range of foods, including dairy products, seafood, meat, eggs, poultry, fruits, and vegetables (2). Through invading, residing and multiplying within the host cells, L. monocytogenes can cause severe infections in newborns, pregnant women, immunocompromised individuals and the elderly (3). Compared to other bacterial pathogens, L. monocytogenes exhibits a stronger propensity to infect the central nervous system (4,5). This facultative intracellular pathogen can cross the blood-brain barrier and lead to L. monocytogenes meningitis.

Epidemiological data indicate that L. monocytogenes accounts for about 4–5% of bacterial meningitis in infants aged <90 days (6,7) and 4.9% of fatal bacterial meningitis in children under 5 years of age (8). In Danish, the incidence rate of L. monocytogenes meningitis among children aged 1 month to 17 years from 2000 to 2017 was 0.024/100,000 (9). The case fatality rate in neonates is as high as 20–30% and 40% of survivors developing neurological sequelae (9). These complications include, but are not limited to hydrocephalus requiring ventriculostomy, brain abscess, brain stem encephalitis or meningoencephalitis (4,5,10,11), which place a heavy burden on patients and their families. During the past three decades, advancements in public health interventions have influenced the epidemiology pattern of L. monocytogenes meningitis. However, there still remain considerable disparities in healthcare accessibility and diagnosis and treatment outcomes across different regions. There is limited research providing information on global trends of L. monocytogenes meningitis, especially in children aged 0–14 years. To fill this gap, we utilized the Global Burden of Disease (GBD) dataset from 1990 to 2021 to comprehensively evaluate the global burden of L. monocytogenes meningitis, aiming to enhance awareness of this critical situation in children. We analysed the mortality and disability-adjusted life years (DALYs) at the global, regional, and national levels and provided insights for the prevention and management of this condition. We present this article in accordance with the STROBE reporting checklist (available at https://tp.amegroups.com/article/view/10.21037/tp-2025-315/rc).

Methods

Data sources

The data utilized in this research are sourced from the 2021 GBD dataset, which provides standardized methodologies to analyse the global and regional burden of 371 diseases, injuries, as well as 88 risk factors across 204 countries and territories from 1990 to 2021 (11). Based on death, DALYs and their respective rates, the global burden of L. monocytogenes meningitis in children aged 0–14 years was assessed and categorized by age, year, gender, region, and sociodemographic index (SDI). Details of this method and statistical modelling have been described elsewhere (12). The collection and analysis comply with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) statement (13). All rates were standardized per 100,000 population.

Definitions

The epidemiological outcomes of L. monocytogenes meningitis in children are conducted by DisMod-MR V.2.1 (Institute for Health Metrics and Evaluation, Washington D.C., USA), a Bayesian meta-regression tool to analyse, model, and estimate deaths, death rates, DALYs and DALY rates for quantifying the burden. L. monocytogenes meningitis was defined as an acute disease with sudden fever, intense headache, nausea, vomiting, neck stiffness and confirmed by positive microbial findings of L. monocytogenes in cerebrospinal fluid (CSF) (14). DALYs are defined as the sum of years healthy life lost due to disease, consisting of years lived with disability (YLD) and years of life lost (YLL) (15). The average annual percentage change (AAPC) is a statistical measure to quantify the trends in mortality and DALY rates from 1990 to 2021 (16). According to age, children were grouped into five categories: <1 year, 12–23 months, 2–4 years, 5–9 years, and 10–14 years. The SDI, a composite measure reflecting social and economic development, was classified based on the total fertility rate (age <25 years), average female education level (age ≥15 years), and geometric mean of per capita income (17). Ranging from 0 to 1, the SDI classified 204 countries and regions into five groups: low, low-middle, middle, high-middle, and high.

Statistical analysis

In this study, we employed death counts, DALYs, corresponding rates and AAPCs to analyse the global burden of L. monocytogenes meningitis in children and quantify trends across different regions.

All statistical values were presented with 95% uncertainty intervals (UIs), generated using the 2.5th and 97.5th percentiles by randomly sampling 1000 times from specific age, gender, location, and year distributions. Pearson correlation analysis was conducted to evaluate the relationships between death, DALYs rates and SDI across 204 countries and territories. Frontier analysis was employed to examine the minimum attainable DALYs determined by the SDI, and to assess the relationships between L. monocytogenes meningitis burdens and socio-demographic development (18). All data management, calculations, and visualizations were performed using R statistical software (version 4.3.1, R Foundation for Statistical Computing) and JD_GBDR (V2.37, Jingding Medical Technology Co., Ltd.). Two-tailed tests were used for all statistical assessments, with P<0.05 indicating statistical significance.

Results

The global trend of deaths and DALYs attributable to L. monocytogenes meningitis from 1990 to 2021

From 1990 to 2021, there had been a substantial reduction in the global burden of L. monocytogenes meningitis among children under 14 years. The number of deaths attributable to L. monocytogenes meningitis decreased from 12,480 (95% UI: 8,930–16,755) to 5,387 (95% UI: 3,607–7,576) and DALYs decreased from 1,100,960 (95% UI: 787,544–1,477,367) to 474,378 (95% UI: 318,189–666,580) (Table 1). The global AAPC of deaths and DALYs also decreased by −0.015 [95% confidence interval (CI): −0.015 to −0.014], −1.286 (95% CI: −1.297 to −1.276) respectively (Table 1, Figure 1). Meanwhile, the mortality and DALYs rates among males were higher than those among females in both 1990 and 2021. Specifically in males, the number of global deaths of L. monocytogenes meningitis fell from 6,798 (95% UI: 4,783–9,108) to 2,968 (95% UI: 1,926–4,363) and DALYs decreased from 600,354 (95% UI: 423,121–804,803) to 261,605 (95% UI: 170,237–384,225). For females, L. monocytogenes meningitis-related global deaths dropped from 5,682 (95% UI: 4,003–7,867) to 2,419 (95% UI: 1,632–3,490) while DALYs reduced from 500,606 (95% UI: 353,072–693,044) to 212,773 (95% UI: 143,731–306,924) (Table 1).

Figure 1 The AAPC of deaths and DALYs associated with L. monocytogenes meningitis in children from 1990 to 2021. (A) Deaths. (B) DALYs. AAPC, average annual percentage change; DALYs, disability-adjusted life years.

Between 1990 and 2021, a notable decline occurred in both mortality and DALYs attributable to L. monocytogenes meningitis across all pediatric age groups (Table S1). The under-1-year age group consistently accounted for the highest proportion of deaths, while the 10–14-year age group exhibited the lowest. The most pronounced reduction was observed in the 12–23-month age group, where deaths decreased from 1,912 (95% UI: 1,274–2,664) to 681 (95% UI: 408–1,033) and DALYs decreased from 169,766 (95% UI: 113,217–236,561) to 60,557 (95% UI: 36,327–91,850) (Table S1). Across all subgroups under 10 years, males consistently exhibited higher mortality and DALY rates compared to females, however, in the 10–14-year age group, mortality burdens were slightly higher in females than that observed in males (Figure 2).

Figure 2 Numbers of deaths and DALYs attributable to L. monocytogenes meningitis by sex and age in 2021. (A) Deaths; (B) DALYs. DALYs, disability-adjusted life years; UI, uncertainty interval.

The trend in 204 countries and territories of deaths and DALYs attributable to L. monocytogenes meningitis from 1990 to 2021

Similar to 1990, the regions with the highest death rates attributable to L. monocytogenes meningitis in 2021 were concentrated in South Asia and parts of Sub-Saharan Africa. Western Sub-Saharan Africa reported the highest rates of mortality and DALYs by 1.06 deaths (95% UI: 0.63–1.67) and 93.32 DALYs per 100 000 population (95% UI: 55.65–146.03), accounting for over 42% of the global burden (Table 1, Figure 3). In contrast, high-income Asia Pacific exhibited the lowest rates, with 0.01 deaths (95% UI: 0–0.01) and 0.50 DALYs per 100,000 population (95% UI = 0.41, 0.61). East Asia achieved the most substantial percentage reductions in L. monocytogenes meningitis-related mortality and DALY rates compared to 1990, with declines of 92.9% (95% UI: −95.0% to −90.2%) and 93.0% (95% UI: −95.0% to −90.3%), respectively (Table 1). Between 1990 and 2021, most countries experienced varying degrees of decline in mortality and DALY rates, except Tokelau and the Republic of Niue. North Macedonia experienced the most significant decline, with a decrease of 95.17% in the mortality rate (95% UI: −96.75% to −92.18%) and 95.07% in DALY rate (95% UI: −96.66% to −92.03%) (Table S2, Figure 3).

Figure 3 Geographical distribution of death and DALY rates attributable to L. monocytogenes meningitis in 204 countries and territories in 2021. (A) Deaths. (B) DALYs. Darker colors indicate higher rates. DALYs, disability-adjusted life years.

The deaths and DALYs attributable to L. monocytogenes meningitis in different SDI level areas

In 2021, the burden of L. monocytogenes meningitis in children under 14 years was concentrated in low and low-middle-SDI regions, accounting for more than 88% of global cases. From 1990 to 2021, mortality and DALY rates attributable to L. monocytogenes meningitis demonstrated a consistent decline across all SDI regions (Figure 4). However, the pace and magnitude of improvement differed significantly across regions stratified by SDI level. In the lowest SDI region, the rates of deaths and DALYs related to L. monocytogenes meningitis were 0.70 per 100,000 individuals (95% UI: 0.44–1.05) and 61.87 per 100,000 individuals (95% UI: 39.13–92.30) by 2021. In contrast, the highest SDI region exhibited the lowest rates with 0.01 deaths per 100,000 individuals (95% UI: 0.01–0.02) and 1.26 DALYs per 100,000 individuals (95% UI: 1.00–1.54), respectively (Table 1). In the period of 1990–2021, the largest percentage reductions in mortality and DALY rates attributable to L. monocytogenes meningitis were observed in the high-middle SDI (89.0% and 89.1%). Notably, the low- and low-middle-SDI regions showed a unique variation: after 2010, mortality rates stabilized in high and high-middle SDI regions stabilized, whereas low and low-middle SDI regions continued to experience declines, reflecting ongoing improvements in these areas (Figure 4).

Figure 4 Trends of deaths and DALYs rates (per 100,000 population) related to L. monocytogenes meningitis from 1990 to 2021 at different SDI levels. (A) Deaths rate; (B) DALYs rate. DALYs, disability-adjusted life years; SDI, sociodemographic index.

At the regional level, a significant negative correlation was observed between SDI and DALY rates (r=−0.8990, P<0.05, Figure 5), indicating that regions with lower SDI scores may bear a disproportionately greater burden of L. monocytogenes meningitis. The burden of Western Sub-Saharan Africa was much higher than global average, whereas Central Latin America, Andean Latin America, East Asia, Eastern Sub-Saharan Africa, Oceania North Africa and Oceania consistently reported lower than global burdens throughout 1990–2021 (Figure 5). Most regions demonstrated an exponential decline in DALY rates with increasing SDI. Among the 204 countries and territories analysed in 2021, the DALY rates for South Sudan, Chad and Nigeria were much higher than others (Figure 6).

Figure 5 Deaths and DALYS rates attributable to L. monocytogenes meningitis across 21 GBD regions by SDI (1990–2021). (A) Deaths rate; (B) DALYs rate. DALYs, disability-adjusted life years; GBD, Global Burden of Disease; SDI, sociodemographic index.

Figure 6 DALYs rates attributable to L. monocytogenes meningitis across 204 countries and territories by SDI in 2021. DALYs, disability-adjusted life years; SDI, sociodemographic index.

Frontier analysis

Frontier analysis was performed to investigate the relationship between the DALYs rates for L. monocytogenes meningitis and the SDI among children under 14 years across 204 countries and territories from 1990 to 2021. Results showed that as the SDI increased, DALYs rates generally decreased and converged towards stability. Specifically, when SDI exceeded 0.8, the frontier trends plateaued, which suggested that DALY values among countries above this threshold were more consistent. A comprehensive analysis of disparities in DALYs rates with similar SDI levels among countries in 2021 was provided in Figure 7. Ethiopia, Pakistan, and India ranked as the top three countries with the largest discrepancies from the frontier. These countries have significantly higher DALY rates compared to peers with similar SDI levels, underscoring the urgent need for targeted health interventions to improve L. monocytogenes meningitis outcomes.

Figure 7 Frontier analysis of SDI and DALYs trends in L. monocytogenes meningitis (1990–2021). DALYs, disability-adjusted life years; SDI, sociodemographic index.

Discussion

To our knowledge, this is the first study focusing on regional, gender and age differences to estimate the L. monocytogenes meningitis burden among children under 14 years of age. Our analysis revealed a substantial downward trend in disease burden indicating significant progress in global L. monocytogenes meningitis prevention and treatment efforts. These results align with previous research on meningitis (8), offering critical evidence for guiding public health policy and resource allocation.

Notably, the data showed significant disparities in the global burden of L. monocytogenes meningitis among genders and age groups. In all regions except South Africa, L. monocytogenes meningitis-associated mortality and DALY rates were higher in males than in females. Previous study has observed that men have an incidence of 1.28 times that of nonpregnant females in adults (19) and another study of immunocompetent children also found that males may have a higher severity of the L. monocytogenes infection compared to females (20). However, conflicting evidence from recent pediatric studies reported a lower incidence of L. monocytogenes meningitis in males (10,21). The underlying mechanisms for these disparities remain elusive. Male individuals displaying preferential susceptibility to some viral, bacterial, parasitic and fungal infections (22). According to statistics, boys consume more meat, milk and egg products than girls, which are common contamination sources for Listeria monocytogenes (23). Current global data on gender differences in L. monocytogenes meningitis are limited, potential contributing factors may be related to biological differences, such as variations in immune response [differential interleukin 10 (IL-10) production], and behavioral exposures, including dietary habits and delays in diagnosis (24,25). Future multinational studies are warranted to elucidate these associations and validate proposed hypotheses. Heightened surveillance of risk factors specific to male children, such as raw food consumption and immune status, may help mitigate disease burden.

Our findings revealed an age-dependent mortality pattern in L. monocytogenes meningitis, peaking in children under the age of 1 year old, while reaching the lowest in children aged 10–14 years. This epidemiological trajectory may reflect age-specific differences in L. monocytogenes infection routes, host immune competence, and behavioral factors. The importance of perinatal Listeria infection should be emphasized in neonatal populations. Through vertical transmission, particularly transplacental infection and amniotic fluid ingestion, L. monocytogenes can cause fetal infection, which leads to miscarriage, stillbirth, and preterm birth, as well as neonatal listeriosis-associated severe outcomes (26,27). Epidemiological data indicated that the onset of Listeria during pregnancy accounted for nearly 43% of total cases, and 14% occurred in late pregnancies (28). More than 90% of newborns with L. monocytogenes infection developed meningitis (29). Post-neonatal susceptibility in infants may arised from immature immune systems, cross-infection within nurseries, dietary diversification, and household storage practices. Moreover, clinical management challenges, including atypical presentations and difficulty of positive blood cultures, further amplify mortality risks in this population. This underscores the imperative for targeted prophylactic interventions and enhanced surveillance systems to mitigate disease progression in high-risk pediatric cohorts.

Additionally, the significant variations between L. monocytogenes meningitis burden and SDI underscore the critical role of socioeconomic factors on health outcomes. It was noted that from 1990 to 2021, the decline in mortality and DALYs rates for L. monocytogenes meningitis in high-SDI regions was more pronounced compared to those of middle/low-SDI regions and the global average. Social challenges in low-SDI settings, including insufficient resources, weak food safety regulation, healthcare accessibility disparities and limited public health awareness, significantly impede effective disease management. Epidemiological evidence illustrates this inequity: the 2013 French MONALISA prospective cohort revealed a 3-fold increased risk of maternal-neonatal listeriosis among women born in Africa (30), while South Africa’s 2017–2018 L. monocytogenes outbreak linked to contaminated meat products resulted in over 1,000 cases (31). In Mali and Senegal, human breast milk L. monocytogenes colonization demonstrates quantitative correlation with maternal acute malnutrition severity (32). Moreover, non-specific clinical manifestations of the early stage and insufficient pathogen detection capabilities in primary hospitals increased the delay in diagnosis of L. monocytogenes meningitis. In India, infections with L. monocytogenes remain largely undiagnosed and under-reported (33). To mitigate the threat of this “refrigeration-tolerant pathogen”, enhanced surveillance and control measures are essential. For food regulation, enforcing monitoring of cattle, sheep, goat and herds can significantly mitigate the impact of listeriosis on livestock and reduce its entry into the food production chain, thereby protecting both animals and public health (34). For susceptible population, improving maternal awareness of Listeria infection and offering necessary dietary guidance to pregnant women can reduce the incidence rate of pregnancy-related listeriosis (35). The French government implemented measures to control Listeria contamination in food processing, leading to a significant decline in cases of pregnancy-related listeriosis from 1984 to 2006 (36). So far, mostly live attenuated vaccines against Listeria have been explored. Despite promising results in animal models, the clinical efficacy of Listeria vaccines remains contentious (35,37). Furthermore, early diagnosis coupled with targeted antimicrobial therapy represents the optimal approach to reduce mortality and prevent disease sequelae. As the second most common pathogen causing hydrocephalus (38), the prognosis of pediatric L. monocytogenes has improved significantly through early antibiotic administration, sustained intensive care, and management of long-term complications in high-income nations. Future efforts must prioritize grassroots health interventions, establish surveillance systems and implement rapid diagnostic methods such as metagenomics for the prevention and control of L. monocytogenes meningitis, especially in low SDI areas.

Frontier analysis integrating SDI and DALYs reveals critical insights into the global burden of L. monocytogenes meningitis from 1990 to 2021. The analysis demonstrates a robust inverse correlation between SDI and age-standardized DALY rates in pediatric populations, underscoring the importance of socio–economic development in improving health outcomes. Ethiopia, Pakistan, and India exhibited the most pronounced deviations from the frontier, suggesting substantial opportunities for burden improvement through targeted interventions and policy reforms in these countries.

There are several limitations inherent in this study. First, the general limitations of the GBD Study should be realized. Variations in health systems, data recording standards and resource allocation across different countries and regions may influence the quality and reliability of data, leading to inaccurate research conclusions. Second, listeriosis is underdiagnosed during the earlier trimesters and cases of early pregnancy loss may not be suspected. And the effects of long-term complications (such as hydrocephalus, epilepsy, etc.) on L. monocytogenes meningitis-related death are not considered. Third, our analysis did not delve into detailed differences between subnational variations such as rural vs. urban areas or coastal vs. inland regions. Finally, intervention-related factors should also be pointed. Over the past decades, different national governments have implemented several interventions to manage LM. This study may lack a comprehensive evaluation of the interventions’ impact on the burden of L. monocytogenes meningitis.

Conclusions

In summary, the overall burden of L. monocytogenes meningitis in 2021 was significantly decreased from that recorded in 1990. Marked differences were also observed across distinct regions, particularly among infants under 1 year and in regions with low SDI. Enhancing financial support for food safety, public health, and strengthening maternal and infant blockade of L. monocytogenes infection, especially in low-and middle-income countries, are crucial steps in improving survival rates and quality of life for L. monocytogenes meningitis.

Acknowledgments

We greatly appreciate all the collaborators of the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 for producing and making these invaluable data publicly accessible.

Footnote

Reporting Checklist: The authors have completed the STROBE reporting checklist. Available at https://tp.amegroups.com/article/view/10.21037/tp-2025-315/rc

Peer Review File: Available at https://tp.amegroups.com/article/view/10.21037/tp-2025-315/prf

Funding: None.

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-2025-315/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

1. Lecuit M. Listeria monocytogenes, a model in infection biology. Cell Microbiol 2020;22:e13186. [Crossref] [PubMed]
2. Lopes-Luz L, Mendonça M, Bernardes Fogaça M, et al. Listeria monocytogenes: review of pathogenesis and virulence determinants-targeted immunological assays. Crit Rev Microbiol 2021;47:647-66. [Crossref] [PubMed]
3. Dos Santos JS, Biduski B, Dos Santos LR. Listeria monocytogenes: health risk and a challenge for food processing establishments. Arch Microbiol 2021;203:5907-19. [Crossref] [PubMed]
4. Ueno A, Ikawa M, Maeda K, et al. Persistent Severe Cerebral Edema with Neutrophil Infiltration Following Listeria Meningitis. Intern Med 2022;61:3431-4. [Crossref] [PubMed]
5. Paranjape N. Rhombencephalitis due to Listeria monocytogenes. IDCases 2021;24:e01081. [Crossref] [PubMed]
6. Okike IO, Johnson AP, Henderson KL, et al. Incidence, etiology, and outcome of bacterial meningitis in infants aged <90 days in the United kingdom and Republic of Ireland: prospective, enhanced, national population-based surveillance. Clin Infect Dis 2014;59:e150-7. [Crossref] [PubMed]
7. Ouchenir L, Renaud C, Khan S, et al. The Epidemiology, Management, and Outcomes of Bacterial Meningitis in Infants. Pediatrics 2017;140:e20170476. [Crossref] [PubMed]
8. Global, regional, and national burden of meningitis and its aetiologies, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2023;22:685-711. [Crossref] [PubMed]
9. Vissing NH, Kristensen K, Mønster MB, et al. Listeria Meningitis in Danish Children 2000-2017: A Rare Event Even in a Country With High Rates of Invasive Listeriosis. Pediatr Infect Dis J 2019;38:e274-6. [Crossref] [PubMed]
10. Brisca G, La Valle A, Campanello C, et al. Listeria meningitis complicated by hydrocephalus in an immunocompetent child: case report and review of the literature. Ital J Pediatr 2020;46:111. [Crossref] [PubMed]
11. Tavares-Gomes L, Polidori M, Monney C, et al. Divergent host-pathogen interactions in neurolisteriosis: cytosolic replication vs. phagosomal dormancy of Listeria monocytogenes in CNS macrophages. Acta Neuropathol 2025;149:63. [Crossref] [PubMed]
12. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024;403:2133-61. [Crossref] [PubMed]
13. Stevens GA, Alkema L, Black RE, et al. Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement. Lancet 2016;388:e19-23. [Crossref] [PubMed]
14. Arslan F, Meynet E, Sunbul M, et al. The clinical features, diagnosis, treatment, and prognosis of neuroinvasive listeriosis: a multinational study. Eur J Clin Microbiol Infect Dis 2015;34:1213-21. [Crossref] [PubMed]
15. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023;402:203-34. [Crossref] [PubMed]
16. Wang S, Zhang T, Wang K, et al. The global burden of childhood diarrheal diseases attributable to suboptimal breastfeeding from 1990 to 2021: an exploratory analysis of estimates from the global burden of disease study. Int Breastfeed J 2025;20:19. [Crossref] [PubMed]
17. Dai H, Alsalhe TA, Chalghaf N, et al. The global burden of disease attributable to high body mass index in 195 countries and territories, 1990-2017: An analysis of the Global Burden of Disease Study. PLoS Med 2020;17:e1003198. [Crossref] [PubMed]
18. Pan H, Zhao Z, Deng Y, et al. The global, regional, and national early-onset colorectal cancer burden and trends from 1990 to 2019: results from the Global Burden of Disease Study 2019. BMC Public Health 2022;22:1896. [Crossref] [PubMed]
19. Pohl AM, Pouillot R, Bazaco MC, et al. Differences Among Incidence Rates of Invasive Listeriosis in the U.S. FoodNet Population by Age, Sex, Race/Ethnicity, and Pregnancy Status, 2008-2016. Foodborne Pathog Dis 2019;16:290-7. [Crossref] [PubMed]
20. Liang ZH, Zhang LH. Listeria monocytogenes men ingitis in two immunocompetent children and a review of the Literature. Advances in Clinical Medicine 2024;14:1456-62.
21. Xia X, Zhang L, Zheng H, et al. Clinical characteristics and prognosis of pediatric Listeria monocytogenes meningitis based on 10-year data from a large children’s hospital in China. Microbiol Spectr 2024;12:e03244-23. [Crossref] [PubMed]
22. Forsyth KS, Jiwrajka N, Lovell CD, et al. The conneXion between sex and immune responses. Nat Rev Immunol 2024;24:487-502. [Crossref] [PubMed]
23. Hähnel E, Sobek C, Ober P, et al. Age, socioeconomic status, and weight status as determinants of dietary patterns among German youth: findings from the LIFE child study. Front Nutr 2025;12:1578176. [Crossref] [PubMed]
24. Wang Y, Wang XJ, Guan HZ, et al. Research advances in immune response mechanism of Listeria monocytogenes meningitis. Journal of International Neurology and Neurosurgery 2020;47:414-7.
25. Pasche B, Kalaydjiev S, Franz TJ, et al. Sex-dependent susceptibility to Listeria monocytogenes infection is mediated by differential interleukin-10 production. Infect Immun 2005;73:5952-60. [Crossref] [PubMed]
26. Li C, Zeng H, Ding X, et al. Perinatal listeriosis patients treated at a maternity hospital in Beijing, China, from 2013-2018. BMC Infect Dis 2020;20:601. [Crossref] [PubMed]
27. Kumar M, Saadaoui M, Al Khodor S. Infections and Pregnancy: Effects on Maternal and Child Health. Front Cell Infect Microbiol 2022;12:873253. [Crossref] [PubMed]
28. Wadhwa Desai R, Smith MA. Pregnancy-related listeriosis. Birth Defects Res 2017;109:324-35. [Crossref] [PubMed]
29. Charlier C, Kermorvant-Duchemin E, Perrodeau E, et al. Neonatal Listeriosis Presentation and Outcome: A Prospective Study of 189 Cases. Clin Infect Dis 2022;74:8-16. [Crossref] [PubMed]
30. Charlier C, Perrodeau É, Leclercq A, et al. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study. Lancet Infect Dis 2017;17:510-9. [Crossref] [PubMed]
31. Thomas J, Govender N, McCarthy KM, et al. Outbreak of Listeriosis in South Africa Associated with Processed Meat. N Engl J Med 2020;382:632-43. [Crossref] [PubMed]
32. Sarr M, Tidjani Alou M, Delerce J, et al. A Listeria monocytogenes clone in human breast milk associated with severe acute malnutrition in West Africa: A multicentric case-controlled study. PLoS Negl Trop Dis 2021;15:e0009555. [Crossref] [PubMed]
33. Barbuddhe SB, Doijad SP, Goesmann A, et al. Presence of a widely disseminated Listeria monocytogenes serotype 4b clone in India. Emerg Microbes Infect 2016;5:e55. [Crossref] [PubMed]
34. Končurat A, Sukalić T. Listeriosis: Characteristics, Occurrence in Domestic Animals, Public Health Significance, Surveillance and Control. Microorganisms 2024;12:2055. [Crossref] [PubMed]
35. Wang Z, Tao X, Liu S, et al. An Update Review on Listeria Infection in Pregnancy. Infect Drug Resist 2021;14:1967-78. [Crossref] [PubMed]
36. Girard D, Leclercq A, Laurent E, et al. Pregnancy-related listeriosis in France, 1984 to 2011, with a focus on 606 cases from 1999 to 2011. Euro Surveill 2014;19:20909. [Crossref] [PubMed]
37. Mayer RL, Verbeke R, Asselman C, et al. Immunopeptidomics-based design of mRNA vaccine formulations against Listeria monocytogenes. Nat Commun 2022;13:6075. [Crossref] [PubMed]
38. Nachmias B, Orenbuch-Harroch E, Makranz C, et al. Early hydrocephalus in Listeria meningitis: Case report and review of the literature. IDCases 2018;14:e00455. [Crossref] [PubMed]