Listeria monocytogenes is a Gram-positive facultative intracellular pathogen that can cause severe invasive infections upon ingestion with contaminated food. Clinically, listerial disease, or listeriosis, most often presents as bacteremia, meningitis or meningoencephalitis, and pregnancy-associated infections manifesting as miscarriage or neonatal sepsis. SUMMARY Listeria monocytogenes is a Gram-positive facultative intracellular pathogen that can cause severe invasive infections upon ingestion with contaminated food. Clinically, listerial disease, or listeriosis, most often presents as bacteremia, meningitis or meningoencephalitis, and pregnancy-associated infections manifesting as miscarriage or neonatal sepsis. Invasive listeriosis is life-threatening and a main cause of foodborne illness leading to hospital admissions in Western countries. Sources of contamination can be identified through international surveillance systems for foodborne bacteria and strains’ genetic data sharing. Large-scale whole genome studies have increased our knowledge on the diversity and evolution of L. monocytogenes, while recent pathophysiological investigations have improved our mechanistic understanding of listeriosis. In this article, we present an overview of human listeriosis with particular focus on relevant features of the causative bacterium, epidemiology, risk groups, pathogenesis, clinical manifestations, and treatment and prevention.

Human Listeriosis

Listeria monocytogenes (LM) is an intracellular, aerobic and facultative anaerobic, Gram-positive bacterium, which is primarily transmitted to humans orally via food. LM could occur in asymptomatic pregnant women; however, fetal infection is a serious condition, entailing premature birth, abortion, sepsis, central nervous system (CNS) involvement, or even death. If a pregnant woman exhibits symptoms, the performance is almost like influenza, such as fever, headache, diarrhea, myalgia, or other digestive-related symptoms. This review collected clinical and empirical results regarding the mechanism, clinical manifestations, obstetrical outcome, diagnosis, treatment, vertical transmission, neonatal infection, and prevention of listeriosi according to articles published in PubMed from January 1, 1980, to March 20, 2021. The early detection and diagnosis of pregnancy-associated listeriosis are significant since sensitive antibiotics are effective at enhancing the prognosis of newborns. Listeriosis can be diagnosed using positive cultures from maternal or neonatal blood, neonatal cerebrospinal fluid (CSF), amniotic fluid, intrauterine mucosa, or the placenta. Two weeks of high-dose intravenous amoxicillin (more than 6 g/day) is recommended for LM pregnant women without allergy. Terminating the pregnancy to save the mother's life should be considered if maternal and fetal conditions aggravate. Neonatal Listeria infection is primarily transmitted through the placenta, which is a critical illness associated with a high mortality rate. The necessary dietary guidance for pregnant women can reduce the incidence rate of pregnancy-related listeriosis.

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An Update Review on Listeria Infection in Pregnancy.

Pregnancy-associated listeriosis is a severe infectious disease and potentially leads to fetal/neonatal fatal, while limited information on pregnancy-associated listeriosis is available in China. This study aimed to reveal the clinical characteristics and outcomes of pregnancy-associated listeriosis cases and provide references for treating and managing this disease.We performed a retrospective study on maternal and neonatal patients with pregnancy-associated listeriosis. The clinical characteristics of pregnancy-associated listeriosis were studied, and the outcome determinants of neonatal listeriosis were explored.14 cases of pregnancy-associated listeriosis were identified. The incidence of pregnancy-associated listeriosis in our hospital was 16.69/100,000 births. All of the 14 maternal patients eventually recovered after delivery shortly with no sequelae. None of the 12 mothers who delivered in this hospital received antepartum first-line empirical treatment. Among the 14 neonatal cases, 1 was late-onset listeriosis and 13 were early-onset cases; 11 survived and 3 died. Fatality rates were significantly higher in outborn neonates (P = 0.005). Besides, higher mortality rates were observed in neonates with lower birth weight (P = 0.038), gestational age < 28 weeks (P = 0.056), and Apgar score (5th min) < 5 (P = 0.056), with marginally significant differences.Pregnancy-associated listeriosis would bring disastrous effects to the neonatal cases, especially to the outborn, low birth weight, and low gestational age of neonates. Timely detection and treatment should be taken seriously for the key neonates. How to early detect L. monocytogenes infected cases, especially in the prenatal stage, remains a serious challenge. 

/pdf/listeriosis-during-pregnancy-a-retrospective-cohort-study-j799dnvh.pdf

Listeriosis during pregnancy: a retrospective cohort study

Pathogens can stick to the surfaces of leaves and ready-to-eat leafy greens are usually eaten without any lethal treatment to remove them. In this study, the peptide zp80 was chemically synthesized and purified. It had α-helix structure by circular dichroism spectroscopy analysis. zp80 reduced aerobic bacteria in ready-to-eat vegetable salad and lettuce. zp80 had MIC values of 2–8 μM against 7 foodborne pathogens, it was 2 μM to Listeria monocytogenes. Growth curve and time-kill curve showed that zp80 exhibited bactericidal mode with partial cell lysis. Confocal microscope indicated that zp80 was able to penetrate inside the cell membrane and distributed in cytoplasm and nucleus. Cell deformation with sunken surface was observed using scanning electron microscope. Further, results of SYTOX green and DiSC3(5) showed that zp80 had membrane depolarization caused by pore formation. After entering cytoplasm of L. monocytogenes, zp80 could bind to DNA, and then precipitated DNA. In addition, zp80 induced the production of intracellular reactive oxygen species (ROS), which played a key role on lethal effect by analysis using SYTO9 and PI. Hurdling treatment with 64 μM zp80 reduced 4.18 log units of L. monocytogenes in fresh-cut lettuce and alleviated browning after 7-day storage.

Controlling Listeria monocytogenes in ready-to-eat leafy greens by amphipathic α-helix peptide zp80 and its antimicrobial mechanisms

Background: Listeriosis is a severe foodborne infection associated with high mortality. Pregnant women and newborns are at a particularly high risk of infection. However, the data on epidemiology of maternal-neonatal listeriosis in Xi’an are little known. The aim of this study was to investigate the epidemiological and clinical features of maternal-neonatal listeriosis in Xi’an. 

A comprehensive analysis of listeriosis in 13 pregnant women and 27 newborns in Xi’an from 2011 to 2020

Listeriosis is a rare but severe foodborne infectious disease. Perinatal listeriosis is often associated with septicemia, central nervous system (CNS) infection, and serious adverse pregnancy outcomes (miscarriage and neonate death). Here we report the characteristics and outcomes of perinatal listeriosis cases treated over 6 years at Beijing Obstetrics and Gynecology Hospital (BOGH), the largest maternity hospital in China. We retrospectively reviewed the records of laboratory-confirmed, pregnancy-associated listeriosis cases treated from January 1, 2013 to December 31, 2018. The clinical manifestations, laboratory results, perinatal complications and outcomes (post-natal follow-up of 6 months) were investigated. In BOGH, 12 perinatal listeriosis cases were diagnosed based on Listeria monocytogenes positive culture, including 10 single pregnancies and 2 twin pregnancies. The corresponding incidence of pregnancy-associated listeriosis was 13.7/100,000 deliveries. Among those cases, four pregnant women and four newborns had septicemia, and two of the neonates with septicemia also suffered CNS infection. All the maternal patients recovered. Two inevitable miscarriages and four fetal stillbirths occurred. Of the eight delivered newborns, six survived, and two died within 2 days from birth. None of the survivors had neurological sequelae during a 6-month follow-up. The overall feto-neonatal fatality rate was 57.1%; notably, this rate was 100% for infections occurring during the second trimester of pregnancy and only 14.3% for those occurring in the third trimester. Perinatal listeriosis is associated with high feto-neonatal mortality, and thus, a public health concern. Additional large-scale studies are needed to strengthen the epidemiological understanding of listeriosis in China.

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Perinatal listeriosis patients treated at a maternity hospital in Beijing, China, from 2013-2018.

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Perinatal listeriosis patients treated at a maternity hospital in Beijing, China, from 2013-2018.