# Vascular Graft Infections Due to Listeria spp.: A Comprehensive Review of the Literature

## TL;DR

This paper reviews rare but serious Listeria infections in vascular grafts, summarizing patient data, diagnostic methods, and treatment approaches.

## Contribution

The study provides a comprehensive review of Listeria vascular graft infections and evaluates novel antibiotics for treatment.

## Key findings

- Most Listeria vascular graft infections occurred in abdominal aortic grafts with a median delay of 28 months post-implantation.
- Ampicillin combined with aminoglycosides was the primary treatment, with low mortality and no recurrence reported.
- Computed tomography and positron emission tomography CT were key diagnostic tools for these infections.

## Abstract

Vascular graft infections are rare but serious complications of vascular surgery. Listeria monocytogenes represents an exceedingly rare yet potentially life-threatening cause. We present a narrative review according to the Scale for the Assessment of Narrative Review Articles (SANRA) criteria, summarizing the existing literature regarding Listeria vascular graft infections. Moreover, we have revised novel potential antibiotics against Listeria spp. A systematic search identified 23 studies involving 39 patients. Most infections affected abdominal aortic grafts (50%), with a median interval of 28 months from graft implantation to infection. Common comorbidities included hypertension (30.8%) and diabetes (18%), with 24% of patients being immunocompromised. Diagnosis was supported by blood cultures (45%) and imaging, particularly computed tomography (CT, 90%) and positron emission tomography CT (PET-CT) in selected cases. Surgical intervention was performed in 55% of patients, while 45% were treated medically. Ampicillin, often combined with an aminoglycoside, was the most common first-line therapy. Median treatment duration was 51 days, with some patients requiring lifelong suppressive antibiotic therapy. Mortality was low (one patient), and no recurrences were reported. This review underscores the diagnostic complexity and evolving management strategies in Listeria spp. vascular graft infections.