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Identification

Listeriosis is a mild febrile condition, but which may cause meningoencephalitis and/or sepsis in newborns and adults [1] Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.. [2]Popa MI, Popa GL. Listeriosis in Pregnancy: a Public Health Problem in Romania? Gineco.ro. 2009; 5 (1): 58-60 [3]***. Management of Pregnant Women With Presumptive Exposure to Listeria monocytogenes. American College of Obstetricians and Gynecologists; 2014; 614. [4] Delgado A. Listeriosis in Pregnancy. J Midwifery Womens Health. Blackwell Publishing LTD; 6 May 2008; 53 (3): 255-9.. [5] ***. Transmission of Listeria Bacteria | Listeria.. [6]Mr. Heymann. Management Manual of infectious diseases. CDC. 2012 [7] Lamont RF and co. Listeriosis in human pregnancy: a systematic review. J. Rina Med. NIH Public Access; May 2011; 39 (3): 227-36.. [8] Bortolussi R. Listeriosis: a primer. CMAJ. Canadian Medical Association; 7 October 2008;179(8):795-7.. [9] Pontello M et al. Listeria monocytogenes serotypes in human infections (Italy, 2000-2010). Ann Ist Super Sanita. 2012;48(2):146-50.. [10] Jackson KA and co. Pregnancy-associated listeriosis. Epidemiol Infect. 17 October 2010;138(10):1503-9.. [11] ***. Diagnosis and Treatment | Listeria | CDC. Centers for Disease Control and Prevention.. [12] ***. Information for Health Professionals and Laboratories | Listeria | CDC. Centers for Disease Control and Prevention. 2017...

 

In adults

In adults the overall mortality rate reaches up to 30% being higher in people over 50 years of age [13] Zhu Q et al. Listeria monocytogenes in Fresh produces: outbreaks, prevalence and contamination levels. Foods. 2017; 6 (21)||. Adults may experience sepsis, meningitis or meningoencephalitis [14]Zhu Q, Gooneratne R, Hussain MA. Listeria monocytogenes in Fresh produces: outbreaks, prevalence and contamination levels. Foods. 2017; 6 (21). [15]***. Management of Pregnant Women … Exposure to Listeria monocytogenes. American College of Obstetricians and Gynecologists; 2014; 614..

 

To the pregnant woman

The pregnant woman infection can cause [16] Popa GL and co. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.. [17] Popa MI and co. Listeriosis in Pregnancy: a Public Health Problem in Romania? Gineco.ro. 2009; 5 (1): 58-60. [18] ***. Management of Pregnant … to Listeria monocytogenes. American College of Obstetricians and Gynecologists; 2014; 614. [19] Delgado A. Listeriosis in Pregnancy… Blackwell Publishing LTD; 6 May 2008; 53 (3): 255-9.:

  • Premature birth
  • Fetal infections
  • Spontaneous abortions

The transmission shall be:

Pregnant women have greater susceptibility to Listeria monocytogenes due to progesterone-induced low cellular immune response [22] Mr. Heymann. Management Manual of infectious diseases. CDC. 2012;~. Listeriosis occurs primarily in the third trimester of pregnancy, but because of the lack of cultures in the fetal tissue resulting from abortion, there is the possibility of subdiagnosis of Listeriosis at the small age of pregnancy [23] Popa MI et al. Listeriosis in Pregnancy… in Romania? Gineco.ro. 2009; 5 (1): 58-60. [24]Mr. Heymann. Management Manual of infectious diseases. CDC. 2012/..

 

Symptoms

Listeriosis to the pregnant woman is manifested with flu-like symptoms:

Listeria infection was associated with spontaneous abortions [27] Mr. Heymann. Management Manual of infectious diseases. CDC. 2012;“. The post partum evolution of the mother is usually uneventful. Listeriosis in pregnant women is hard to diagnose due to non-specific clinical forms, however, any febrile episode occurring during pregnancy must be suspected and investigated for listeriosis by blood cultures (unless there is an evident cause) [28] Popa MI et al. Listeriosis in Pregnancy… in Romania? Gineco.ro. 2009; 5 (1): 58-60.| [29]Mr. Heymann. Management Manual of infectious diseases. CDC. 2012/’..

In newborn

The mortality rate in the newborn reaches up to 50% [30] Bortolussi R. Listeriosis: a primer. CMAJ. Canadian Medical Association; 7 October 2008;179(8):795-7.~..

The Listeriosis prognosis for the fetus is very poor, especially if the transmission takes place at a small age of pregnancy, when it balances with abortion [31]***. Management of Pregnant … Presumptive Exposure to Listeria monocytogenes. American College of Obstetricians and Gynecologists; 2014; 614. [32] Bortolussi R. Listeriosis: a primer. CMAJ. Canadian Medical Association; 7 October 2008;179(8):795-7.`’`.

In newborn there are frequently two distinct clinical forms.

Diagnosis

Laboratory diagnosis in Listeria monocytogenes infections is bacteriological, directly, by isolating and identifying the bacterium [40]Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.“. [41]Popa MI, Popa GL. Listeriosis in Pregnancy: a Public Health Problem in Romania? Gineco.ro. 2009; 5 (1): 58-60.’~.

To the pregnant woman

Due to the absence of digestive manifestations, the diagnosis of Listeriosis in pregnant women can be difficult [42]Popa MI and co. Listeriosis in Pregnancy… Romania? Gineco.ro. 2009; 5 (1): 58-60. [43] ***. Diagnosis and Treatment | Listeria | CDC. Centers for Disease Control and Prevention.’.`.. Blood counts can highlight leukocytosis, but this is an unspecific change [44]Mr. Heymann. Management Manual of infectious diseases. CDC. 2012.~..

The isolation and identification of the bacterium is made of blood, cerebrospinal fluid, amniotic fluid, placenta, fetal tissue, or contaminated pathological products: faeces, genital secretions, food, depending on the case [45] Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.`~.. [46] Popa MI, Popa GL. Listeriosis in Pregnancy… Romania? Gineco.ro. 2009; 5 (1): 58-60. [47] ***. Diagnosis and Treatment | Listeria | CDC. Centers for Disease Control and Prevention.|’~.. The Centre for Disease Control and Prevention in the United States of America (Centers for Disease Control and Prevention, CDC) does not recommend the use of contaminated pathological samples [48] ***. Diagnosis and Treatment | Listeria | CDC. Centers for Disease Control and Prevention.|~..

 

In newborn

In the case of suspicion of neonatal listeriosis will be harvested meconium immediately after birth, prior to the occurrence of intestinal polymicrobial colonization [49]Mr. Heymann. Management Manual of infectious diseases. CDC. 2012|'.

Both the pregnant women and newborn, in the bacteriological laboratory diagnosis, are carried out the microscopic examination of smears in the pathological product, but in most cases identification of L. monocytogenes is difficult due to its intracellular location [50] Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.~|. The identification of the micro-organism after cultivation on suitable culture media will be carried out [51] Popa GL et al. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010’`.. [52]Popa MI, Popa GL. Listeriosis in Pregnancy: a Public Health Problem in Romania? Gineco.ro. 2009; 5 (1): 58-60.’|'.

Two techniques can be used to achieve a faster result:

After identification L. monocytogenes must be performed antibiogram to know the sensitivity to antibiotics, useful in determining the treatment [56] Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.~~.

An extremely important and sometimes overlooked aspect is that during pregnancy any febrile episode should be  investigated by performing hemocultures. If the listeriosis is suspected, the laboratory physician should be informed of this (e.g. The colonies of Listeria monocytogenes can be confused with those of Corynebacterium Diphteriae) [57] Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.|~|.

If pregnant is febrile at birth, the bacteriological examination of the placenta and of the pathological products collected from the newborn [58]***. Management of Pregnant … Listeria monocytogenes. American College of Obstetricians and Gynecologists; 2014; 614.~ will be performed.

An error commonly encountered in the current medical practice is the use of serological tests for the determination of anti L. IgG and IgM antibody monocytogenes for “screening and diagnosis Listeriosis” in pregnant woman. There are “cross” reactions, false positive reactions, false negative reactions, and in this context it is not advisable to perform this test [59] Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010..”.. [60]Popa MI, Popa GL. Listeriosis in Pregnancy … Romania? Gineco.ro. 2009; 5 (1): 58-60..

 

Infectious agent

Listeria monocytogenes, species-type of Listeria genus, pathogenic to humans and animals, is a Gram positive bacillus, optional intracellular (can be multiplied in macrophages, monocytes) [61] Popa GL, Palm MI. Medical Microbiology … | microbiologie.ro. 2010. . Human infections are usually determined by serotypes 1/2a; 1/2b; 1/2c and 4b [62] Popa GL, Palm MI. Medical Microbiology … | microbiologie.ro. 2010.`  [63]Mr. Heymann. Management …infectious diseases. CDC. 2012 [64] Pontello M et al. Listeria monocytogenes serotypes in human infections… Ann Ist Super Sanita. 2012;48(2):146-50.. [65] ***. Information for Health Professionals and Laboratories | Listeria | CDC. Centers for Disease Control and Prevention. 2017.|’.

In Romania a circulating serotype is 1/2a, while 4b serotype is met in West.

 

Incidence and prevalence

It is a less diagnosed infection, being associated with the consumption of:

Infection may occur in the outbreak, may be asymptomatic but also with potentially fatal symptoms [68]Popa MI, Popa GL. Listeriosis in Pregnancy: a Public Health Problem in Romania? Gineco.ro. 2009; 5 (1): 58-60.'. Listeriosis is 18 times more common in pregnant women compared to the general population and represents 27% of the total cases of listeriosis [69]***. People at Risk | Listeria. Centers for Disease Control and Prevention. 2017.”.. Prevalence of congenital listeriosis varies between 8.6-17.4 to 100,000 births [70] Jackson KA et al. Pregnancy-associated listeriosis. Epidemiol Infect. 17 October 2010;138(10):1503-9.’.. The largest epidemic of listeriosis took place in 1985 in Los Angeles, USA, and from 142 reported listeriosis cases, 65.5% were pregnant women [71] Linnan MJ et al. Epidemic Listeriosis Associated with Mexican-Style Cheese. N Engl J Med. 29 September 1988;319(13):823-8...

Data from two studies report spontaneous abortions in 10-20% of cases and premature birth in 50% of cases, and the fetus death in the uterus in about 11% of cases [72] Lamont RF et al. Listeriosis in human pregnancy: a systematic review. J. Rina Med. NIH Public Access; May 2011; 39 (3): 227-36.’ [73] Bortolussi R. Listeriosis: a primer. CMAJ. Canadian Medical Association; 7 October 2008;179(8):795-7.~... It is recommended that women with spontaneous abortions be investigated for vaginal listeriosis [74]***. Management … to Listeria monocytogenes. American College of Obstetricians and Gynecologists; 2014; 614.. [75] Lamont RF et al. Listeriosis in human pregnancy: a systematic review. J. Rina Med. NIH Public Access; May 2011; 39 (3): 227-36./... Although the pregnant manifestations caused by listeriosis are mild, congenital listeriosis is severe, potentially fatal. Congenital listeriosis has an incidence of 8.6/100,000 births, being one of the most common causes of neonatal meningitis [76] Jackson KA et al. Pregnancy-associated listeriosis. Epidemiol Infect. 17 October 2010;138(10):1503-9.`’.. The mortality rate is high: 20-60% [77]***. Incidence and Trends … Surveillance Network, 10 U.S. Sites, 1996–2012. MMWR Morb Mortal Wkly Rep. 2012;62(15):283-7...

 

Source

Listeria monocytogenes is a widespread germ in nature and infects [78] McLauchlin J et al. Listeria monocytogenes … risk assessment of foods. Int J Food Microbiol. April 2004;92(1):15-33.. :

  • Domestic animals, in particular sheep,
  • Wild Animals,
  • Birds.

The bacterium is found in:

 

Listeria monocytogenes is very resistant to the external environment and to various chemical agents as well as to refrigerator temperature; can survive for months in foodstuffs [81] Popa GL et al. Medical Microbiology …Course | microbiologie.ro. 2010.. [82]Mr. Heymann. Management Manual … diseases. CDC. 2012.

Man can also be a bacterial tank; asymptomatic excretion of bacteria through fecal matter is encountered in slaughterhouse workers [83]Mr. Heymann. Management Manual … diseases. CDC. 2012.~ [84] McLauchlin J and co. Listeria … risk assessment of foods. Int J Food Microbiol. April 2004;92(1):15-33... This pathway to remove the bacterium has been proven for several months [85]Mr. Heymann. Management Manual of infectious diseases. CDC. 2012|~.. Studies have shown that the bacterium can form a biofilm that allows the attachment to stainless steel surfaces with increased resistance to disinfectants and antimicrobial agents [86] ***. Transmission of Listeria Bacteria | Listeria.`. [87] Mr. Heymann. Management Manual… diseases. CDC. 2012..

No secondary infections have been identified in household contacts [88] Mr. Heymann. Management Manual of infectious diseases. CDC. 2012~`~ [89] ***. People at Risk | Listeria. Centers for Disease Control and Prevention. 2017.|..

 

Method of transmission

The main transmission pathways are: digestive and maternal-foetal [90] Popa GL, Palm MI. Medical Microbiology Vol. 1 … | microbiologie.ro. 2010.. [91] Popa MI, Popa GL. Listeriosis in Pregnancy… in Romania? Gineco.ro. 2009; 5 (1): 58-60.~ [92] ***. Transmission of Listeria Bacteria | Listeria.~’. [93] Mr. Heymann. Management Manual of infectious diseases. CDC. 2012.`| [94] Lamont RF et al. Listeriosis in human pregnancy … J. Rina Med. NIH Public Access; May 2011; 39 (3): 227-36.. [95] ***. Information for Health … | Listeria | CDC. Centers for Disease Control and Prevention. 2017.. [96]***. People at Risk | Listeria. Centers for Disease Control and Prevention. 2017.|`’..

Cases of listeriosis in pregnant women are more frequently associated with food consumption such as milk and dairy products, meat, fish [97] **. Transmission of Listeria Bacteria | Listeria.|~ [98] Little CL and co. Attribution of Human Listeria … Salmonella Source Attribution Model. Foodborne Pathog Dis. July 2010;7(7):749-56.|. [99] ***. Everything You Never Wanted to Know About Listeria, But Need To. Food Poison J. 2013.`|..

It can also be transmitted through direct contact with infectious material, in which case Papillo lesions appear on hands and arms [100] Mr. Heymann. Management Manual of infectious diseases. CDC. 2012~*. [101] ***. People at Risk | Listeria. Centers for Disease Control and Prevention. 2017.|...

Maternal-foetal transmission may be intrauterine, as long as the woman is pregnant or at birth when the newborn passes through the infected birth canal [102] Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.`..

 

Risk groups

They are persons working with domestic animals or birds, or those who manipulate and process raw meat [103] ***. People at Risk | Listeria… and Prevention. 2017...

At risk are also pregnant women who consume foods such as milk and dairy products, meat, fish, heat-unprocessed sausages.

Fetuses and newborn infants are also extremely sensitive to people with impaired immune systems, people with malignant tumors, organ transplant, diabetics, cirrhotic, patients with renal and cardiac diseases, HIV infection and old people [104] Mr. Heymann. Management Manual of infectious diseases. CDC. 2012~ [105] ***. People at Risk | Listeria. Centers for Disease Control and Prevention. 2017..|..

 

Incubation period

It is variable and longer than to other pathogens with food origin. On average is 3 weeks (limits 3-70 days) and only one exposure to the contaminated product is sufficient [106]Mr. Heymann. Management … infectious diseases. CDC. 2012. .

 

Infectiousness Period

Mothers of newly infected infants can eliminate bacteria by vaginal secretions and urine for 7-10 days after birth, rarely a longer period [107] ***. Everything You Never Wanted to Know … Need To. Food Poison J. 2013...

Asymptomatic carriers can excrete bacteria through faeces, several months [108]Mr. Heymann. Management … infectious diseases. CDC. 2012.~.’ .

Prophylaxis

Epidemiological investigations have shown that Listeria monocytogenes can contaminate almost any type of food, but most diseases have as cause the precooked products (e.g. Hotdogs, dairy products such as unpasteurized, inadequately pasteurized or post-pasteurized cheese specialities) [109]Mr. Heymann. Management … infectious diseases. CDC. 2012.’.~ [110] Little CL and co. Attribution of Human Listeria…the Hald Salmonella Source Attribution Model. Foodborne Pathog Dis. July 2010;7(7):749-56...

Since L. monocytogenes is a ubicuitar microorganism, it can be encountered and isolated from processed foods, raw meat and even some prepared vegetables. For this reason, the creation of guides that completely prevent exposure to Listeria moncytogenes is almost impossible.

Complying with CDC recommendations for the prevention of infection is an important strategy for reducing the risk of listeriosis, including congenital listeriosis.

CDC recommendations to prevent infection with Listeria monocytogenes in pregnant women:

 

Vaccination

As there is no vaccine, hygiene measures are essential in preventing listeriosis.

 

Birth to female genital infected with Listeria monocytogenes

If the woman is colonized in the vagina with Listeria the Caesarean section is recommended.

 

Breastfeeding

No special recommendations.

Treatment

Penicillin or ampicillin together with aminoglycosides can be used after confirmation of sensitivity by antibiogram [119] Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010.~.. [120]Mr. Heymann. Management Manual of infectious diseases. CDC. 2012~|'.

 

 

Bibliography

  1. Popa GL, Palm MI. Medical Microbiology Vol. 1 (2010)-Course | microbiologie.ro. 2010. Retrieved from: http://www.microbiologie.ro/microbiologie-medicală-vol-1-2010-curs/microbiologie-medicală-vol-1-2010-curs
  2. Popa MI, Popa GL. Listeriosis in Pregnancy: a Public Health Problem in Romania? Gineco.ro. 2009; 5 (1): 58-60.
  3. Zhu Q, Gooneratne R, Hussain MA. Listeria monocytogenes in Fresh produces: outbreaks, prevalence and contamination levels. Foods. 2017; 6 (21).
  4. ***. Management of Pregnant Women With Presumptive Exposure to Listeria monocytogenes. American College of Obstetricians and Gynecologists; 2014; 614.
  5. Delgado A. Listeriosis in Pregnancy. J Midwifery Womens Health. Blackwell Publishing LTD; 6 May 2008; 53 (3): 255-9. Retrieved from: http://linkinghub.elsevier.com/retrieve/pii/S1526952308000068
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  7. Mr. Heymann. Management Manual of infectious diseases. CDC. 2012;
  8. Lamont RF, Sobel J, Mazaki-Tovi S, Kusanovic JP, Vaisbuch E, Kim SK, et al. Listeriosis in human pregnancy: a systematic review. J. Rina Med. NIH Public Access; May 2011; 39 (3): 227-36. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/21517700
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  10. Pontello M, Guaita A, Sala G, Cipolla M, Gattuso A, Sonnessa M, et al. Listeria monocytogenes serotypes in human infections (Italy, 2000-2010). Ann Ist Super Sanita. 2012;48(2):146-50. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/22751557
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  15. ***. People at Risk | Listeria. Centers for Disease Control and Prevention. 2017. Retrieved from: https://www.cdc.gov/listeria/risk.html
  16. Linnan MJ, Mascola L, Lou XD, Goulet V, May S, Salminen C, et al. Epidemic Listeriosis Associated with Mexican-Style Cheese. N Engl J Med. 29 September 1988;319(13):823-8. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/3137471
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  19. ***. Everything You Never Wanted to Know About Listeria, But Need To. Food Poison J. 2013. Retrieved from: http://www.foodpoisonjournal.com/food-poisoning-resources/everything-you-never-wanted-to-know-about-listeria-but-need-to/
  20. ***. Checklist of Foods to Avoid During Pregnancy. Food Safety. U.S. Department of Health and Human Services. Retrieved from: https://www.foodsafety.gov/risk/pregnant/chklist_pregnancy.html
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About Corneliu Zaharia


TORCH.RO nu îsi propune sa înlocuiasca consultul medical de specialitate, informatia prezentata pe acest site are un caracter informativ. Pentru mai multe informatii consultati Principii de Etica