Spontaneous bacterial peritonitis caused by Listeria monocytogenes: A rare infection with very high leukocyte counts in ascitic fluid-case report and review of the literature.

We present a rare case of Listeria monocytogenes-induced spontaneous bacterial peritonitis (SBP) in cirrhosis. Examination of the patient's peritoneal fluid revealed an extremely high leukocyte count. We suspect, that the patient belongs to 1% of individuals in which Listeria monocytogenes is part of the intestinal flora. Cephalosporins as empiric antibiotics have a Listeria gap. A combination of aminopenicillin and aminoglycoside is recommended. Therefore, early microbiological diagnosis from ascites and blood is essential. Listeria should be considered as a rare cause of SBP, especially in case of very high leukocyte count in peritoneal fluid or lack of response to empiric therapy.

[Evaluation of a SARS-CoV-2 test strategy in a southwestern university hospital at the beginning of the COVID-19 pandemic]. / Evaluation einer SARS-CoV-2-Teststrategie zu Beginn der COVID-19-Pandemie in einem südwestdeutschen Universitätsklinikum.

BACKGROUND: At the beginning of the COVID-19 pandemic, the German Robert Koch Institute (RKI) published several guidelines addressing the medical health services helping to detect SARS CoV­2. Needing an available and specific test strategy regarding SARS-CoV­2, our own test strategy strictly followed these testing criteria. MATERIALS AND METHODS: Using a retrospective analysis, we verified if such a test strategy was an effective tool in the context of infection prevention control and as reliable SARS-CoV­2 detection. Therefore, we analysed our own test results of suspected SARS-CoV­2 cases between 26 February and 6 April 2020. Additionally, we used a geovisualisation tool to visualise test frequencies and positive test results within different districts of Mannheim based on people's addresses. RESULTS: There were on average 7% positive test results of SARS-CoV­2 within a population with typical symptoms of COVID-19 (n = 2808). There was no positive test result within an asymptomatic population (n = 448). However, one positive test result turned out to be a nosocomial infection. Finally, geovisualisation highlighted a shift of test frequencies and local positive rates for SARS-CoV­2 from one district of Mannheim to another. DISCUSSION: In conclusion, our test strategy strictly based on testing criteria suggested by the Robert Koch Institute resulted in a steady rate of positive tests and allowed us to increase test capacity without causing numbers of nosocomial infections of COVID-19. Geovisualisation tools can offer support in analysing an ongoing spread of transmissible diseases. In the future, they could be used as helpful tools for infection prevention control, for example in the context of vaccination programs.