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Bongiovanni M, Cavallo C, Barda B, Strulak L, Bernasconi E, Cardia A. Clinical Findings of Listeria monocytogenes Infections with a Special Focus on Bone Localizations. Microorganisms 2024; 12:178. [PMID: 38258004 PMCID: PMC10821090 DOI: 10.3390/microorganisms12010178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Listeria monocytogenes is a Gram-positive pathogenic bacterium which can be found in soil or water. Infection with the microorganism can occur after ingestion of contaminated food products. Small and large outbreaks of listeriosis have been described in the past. L. monocytogenes can cause a number of different clinical syndromes, most frequently sepsis, meningitis, and rhombencephalitis, particularly in immunocompromised hosts. L. monocytogenes systemic infections can develop following tissue penetration across the gastrointestinal tract or to hematogenous spread to sterile sites, possibly evolving towards bacteremia. L. monocytogenes only rarely causes bone or joint infections, usually in the context of prosthetic material that can provide a site for bacterial seeding. We describe here the clinical findings of invasive listeriosis, mainly focusing on the diagnosis, clinical management, and treatment of bone and vertebral infections occurring in the context of invasive listeriosis.
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Affiliation(s)
- Marco Bongiovanni
- Division of Infectious Diseases, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland; (B.B.); (E.B.)
| | - Claudio Cavallo
- Division of Neurosurgery, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland; (C.C.); (L.S.)
| | - Beatrice Barda
- Division of Infectious Diseases, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland; (B.B.); (E.B.)
| | - Lukasz Strulak
- Division of Neurosurgery, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland; (C.C.); (L.S.)
| | - Enos Bernasconi
- Division of Infectious Diseases, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland; (B.B.); (E.B.)
| | - Andrea Cardia
- Division of Neurosurgery, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland; (C.C.); (L.S.)
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Abstract
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.
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Affiliation(s)
- Merel M Koopmans
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Matthijs C Brouwer
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - José A Vázquez-Boland
- Infection Medicine, Edinburgh Medical School (Biomedical Sciences), University of Edinburgh, Edinburgh, United Kingdom
| | - Diederik van de Beek
- Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands
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A Whole Genome Sequencing-Based Epidemiological Investigation of a Pregnancy-Related Invasive Listeriosis Case in Central Italy. Pathogens 2022; 11:pathogens11060667. [PMID: 35745521 PMCID: PMC9228178 DOI: 10.3390/pathogens11060667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
Listeriosis is currently the fifth most common foodborne disease in Europe. Most cases are sporadic; however, outbreaks have also been reported. Compared to other foodborne infections, listeriosis has a modest incidence but can cause life-threatening complications, especially in elderly or immunocompromised people and pregnant women. In the latter case, the pathology can be the cause of premature birth or spontaneous abortion, especially if the fetus is affected during the first months of gestation. The causative agent of listeriosis, Listeria monocytogenes, is characterized by the innate ability to survive in the environment and in food, even in adverse conditions and for long periods. Ready-to-eat food represents the category most at risk for contracting listeriosis. This study presents the result of an investigation carried out on a case of maternal-fetal transmission of listeriosis which occurred in 2020 in central Italy and which was linked, with a retrospective approach, to other cases residing in the same city of the pregnant woman. Thanks to the use of next-generation sequencing methodologies, it was possible to identify an outbreak of infection, linked to the consumption of ready-to-eat sliced products sold in a supermarket in the investigated city.
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McLauchlin J, Amar CFL, Grant KA. Neonatal cross-infection due to Listeria monocytogenes. Epidemiol Infect 2022; 150:1-31. [PMID: 35300745 PMCID: PMC9044523 DOI: 10.1017/s0950268822000504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/07/2022] [Accepted: 03/13/2022] [Indexed: 11/07/2022] Open
Abstract
Neonatal listeriosis is rare and detecting more than one case together would be unlikely without a causal link. Thirty-five instances of neonatal listeriosis where cross-infection occurred in the UK and Ireland were reviewed together with 29 other similar episodes reported elsewhere. All instances comprised an infant who was ill at or within one day of delivery and who had direct or indirect contact with a second infant, or in the minority, two or more infants, who then usually developed meningitis 6 to 12 days later. In most instances, the infants were nursed on the same day in obstetric units or new-born nurseries and consequently, staff and equipment were common: hence, the likely route of transmission was via direct or indirect neonate to neonate contact. In one instance, a stethoscope was used on both infants nursed in different parts of the same hospital. In a further incident, the mother of the early-onset infant cuddled a baby from an adjacent bed who developed meningitis 12 days later. The largest outbreak occurred in Costa Rica where nine neonatal listeriosis cases resulted after bathing in mineral-oil shortly after birth which had been contaminated from the early-onset index case.
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Affiliation(s)
- J. McLauchlin
- UK Health Security Agency, Food Water and Environmental Microbiology Services, National Infection Service, Colindale, London NW9 5EQ, UK
| | - C. F. L. Amar
- UK Health Security Agency, Gastrointestinal Bacteria Reference Unit, National Infection Service, 61 Colindale Avenue, London NW9 5EQ, UK
| | - K. A. Grant
- UK Health Security Agency, Gastrointestinal Bacteria Reference Unit, National Infection Service, 61 Colindale Avenue, London NW9 5EQ, UK
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Abu-Raya B, Jost M, Bettinger JA, Bortolussi R, Grabowski J, Lacaze-Masmonteil T, Robinson JL, Posfay-Barbe KM, Galanis E, Schutt E, Mäusezahl M, Kollmann TR. Listeriosis in infants: Prospective surveillance studies in Canada and Switzerland. Paediatr Child Health 2021; 26:e277-e282. [PMID: 34880959 DOI: 10.1093/pch/pxab035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives International data on listeriosis during infancy from large populations are essential to guide evidence-based empiric antibiotic guidelines for sepsis in infancy. We aimed to determine the incidence, clinical manifestations, and outcome of listeriosis in infants <6 months of age in Canada and Switzerland. Methods Prospective, active surveillance of listeriosis in infants <6 months of age was conducted through the Canadian Paediatric Surveillance Program (May 2015 to April 2017) and the Swiss Paediatric Surveillance Unit (April 2017 to March 2018). Confirmed and probable cases were included. Results In Canada, eight sporadic listeriosis cases were reported (incidence, 1.1/100,000 live births/year). In Switzerland, four cases were reported (incidence, 4.5/100,000 live births/year) of which three were part of a confirmed outbreak with an unclear source. In the two countries, eight of the 12 cases (66.6%) presented as early-onset disease (within the first 7 days of life) and none presented after 28 days life. Conclusions Neonatal listeriosis is rare. Infants presenting with sepsis, especially after 4 weeks of life, may not routinely require empiric antibiotic coverage for listeriosis. Outbreak-related cases still occur. Continued surveillance is important.
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Affiliation(s)
- Bahaa Abu-Raya
- Vaccine Evaluation Center, British Columbia Children's Hospital, Department of Pediatrics, Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia,Canada
| | - Marianne Jost
- Federal Office of Public Health, Department of communicable diseases, Bern, Switzerland
| | - Julie A Bettinger
- Vaccine Evaluation Center, British Columbia Children's Hospital, Department of Pediatrics, Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia,Canada
| | - Robert Bortolussi
- Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Janet Grabowski
- Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Thierry Lacaze-Masmonteil
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Klara M Posfay-Barbe
- Department of Pediatrics, Pediatric Infectious Diseases Unit, University Hospitals of Geneva, Geneva, Switzerland
| | - Eleni Galanis
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Mirjam Mäusezahl
- Federal Office of Public Health, Department of communicable diseases, Bern, Switzerland
| | - Tobias R Kollmann
- Vaccine Evaluation Center, British Columbia Children's Hospital, Department of Pediatrics, Division of Infectious Diseases, University of British Columbia, Vancouver, British Columbia,Canada
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The seasonality, steroid use, and lower ratio of neutrophil to lymphocyte associated with bacteremia of Listeria monocytogenes in Japan from 2010 to 2019: a case-control study. BMC Infect Dis 2021; 21:1212. [PMID: 34865638 PMCID: PMC8647357 DOI: 10.1186/s12879-021-06926-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022] Open
Abstract
Background Despite having a high mortality rate, Asian studies about the characteristics of adult listeriosis are limited. We investigated the incidence of listeriosis per admissions, associated factors, and rate of mortality in listeriosis, compared with non-listeriosis. Methods We recorded the incidence of listeriosis per 10,000 admissions and conducted a case–control study from January 1, 2010, to December 31, 2019, at Tokyo Medical University Hospital (TMUH) in Japan. Cases were defined as adult with listeriosis that was bacteremia due to L. monocytogenes. Controls, defined as adult with non-listeriosis bacteremia due to other pathogens, were matched by age and clinical department to cases. We analyzed differences in seasonality, including warm season (defined as the period from May to October), medication including steroids, laboratory findings, and mortality. The odds ratio and p value between the cases group and control group were calculated using a chi-square test and Fisher’s exact test. Results The incidence of listeriosis per 10,000 admissions to TMUH was 0.51. Eleven patients, excluding one neonate, were included in the case group. Twenty-six patients, excluding one patient because of contamination and one patient because of insufficient medical record, were included in the control group. Listeriosis onset was associated with the warm season (90.9% vs. 53.8%; p = 0.033), steroid use (54.5% vs. 19.2%; p = 0.042), and a lower ratio of neutrophils to lymphocytes (9.46 vs. 18.44; p = 0.015). The 30-day mortality rate of listeriosis was similar to non-listeriosis (18.3% vs. 19.2%; p = 0.619). Conclusion The incidence of listeriosis per admissions in this study was similar to that in other Asian countries. Factors associated with listeriosis were the warm season, steroid use, and a lower ratio of neutrophils to lymphocytes. Additionally, the 30-day mortality rate was similarly high in both the listeriosis and non-listeriosis groups.
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Russini V, Spaziante M, Zottola T, Fermani AG, Di Giampietro G, Blanco G, Fabietti P, Marrone R, Parisella R, Parrocchia S, Bossù T, Bilei S, De Marchis ML. A Nosocomial Outbreak of Invasive Listeriosis in An Italian Hospital: Epidemiological and Genomic Features. Pathogens 2021; 10:pathogens10050591. [PMID: 34066208 PMCID: PMC8150339 DOI: 10.3390/pathogens10050591] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/29/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Listeria monocytogenes (L. monocytogenes) is a widespread opportunistic pathogen that causes the listeriosis foodborne disease. This bacterium has become a common contaminant of handled food, and a relevant public health issue. Here we describe a nosocomial outbreak of listeriosis caused by an ST451 strain of L. monocytogenes involving three cancer and one immunocompromised patients hospitalized in different units from the same hospital during September and October 2020. The epidemiological investigation was conducted using traditional microbiological methodology combined with a whole genome sequencing approach. The source of contamination was identified in the kitchen hospital, where a meat slicer used to prepare patients’ meals was tested positive to the same sequence type (ST) of L. monocytogenes. This is the first report of an outbreak of listeriosis caused by ST451 in Italy.
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Affiliation(s)
- Valeria Russini
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Martina Spaziante
- Regional Service Surveillance and Control for Infectious Diseases (SERESMI), National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, Italy;
| | - Tiziana Zottola
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Latina, 04100 Latina, Italy;
| | | | - Gina Di Giampietro
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Giovanni Blanco
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Paolo Fabietti
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Riccardo Marrone
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Roberta Parisella
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Sergio Parrocchia
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Teresa Bossù
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Stefano Bilei
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Maria Laura De Marchis
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
- Correspondence:
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Abstract
Listeria monocytogenes is a Gram-positive pathogenic bacterium which can be found in soil or water. Infection with the organism can develop after ingestion of contaminated food products. Small and large outbreaks of listeriosis have been described. Listeria monocytogenes can cause a number of clinical syndromes, most frequently sepsis, meningitis, and rhombencephalitis, particularly in immunocompromised hosts. The latter syndrome mimics the veterinary infection in ruminants called "circling disease". Neonatal infection can occur as a result of maternal chorioamnionitis ("early onset" sepsis) or through passage through a birth canal colonized with Listeria from the gastrointestinal tract. ("late onset" meningitis). Treatment of listeriosis is usually with a combination of ampicillin and an aminoglycoside but other regimens have been used. The mortality rate is high, reflecting the combination of an immunocompromised host and an often delayed diagnosis.
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10
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Wadhwa Desai R, Smith MA. Pregnancy-related listeriosis. Birth Defects Res 2018; 109:324-335. [PMID: 28398675 DOI: 10.1002/bdr2.1012] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 01/19/2017] [Accepted: 01/21/2017] [Indexed: 11/12/2022]
Abstract
About one in seven cases of listeriosis occurs in pregnant women, and, although listeriosis is rare, it is the third leading cause of death from food-borne infections. Pregnancy-related listeriosis increases the risk for fetal and neonatal mortality by approximately 21%. During pregnancy, infections are more likely to occur in the third trimester (66%) than the first trimester (3%). However, fetal and neonatal adverse effects are less common as gestational age increases or with older gestational age at birth. Pregnant women seem highly susceptible in some listeriosis outbreaks making up a large percentage of cases, whereas others contain very few. Whether this results from differences in strains of L. monocytogenes, exposures, or other factors remains to be determined. Food and Agriculture Organization of United Nations/World Health Organization (FAO/WHO) estimates the human lethal dose for 50% (LD50 ) for fetal/neonatal loss is 1.9 × 106 colony forming units (CFUs) L. monocytogenes. Animal models have been developed for pregnancy-related listeriosis showing similar susceptibility and clinical outcomes as in humans. Nonhuman primate and guinea pig animal models have similar (LD50 ) values to the estimated human LD50 . Additional animal studies are needed to understand the pathways leading to fetal and neonatal listeriosis in humans. More information is needed to understand dose response, to model risk for listeriosis at lower concentrations, and to determine why some pregnant women may be more susceptible than others. To better treat listeriosis during pregnancy, biomarkers for early diagnosis of listeriosis are also needed. Last, pregnant women need to be educated about avoiding high-risk foods, like Mexican-style cheese and ready-to-eat meats. Birth Defects Research 109:324-335, 2017.© 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Rahat Wadhwa Desai
- Interdisciplinary Toxicology Program, Center for Food Safety, University of Georgia, Athens, Georgia.,Regenerative Bioscience Center, University of Georgia, Athens, Georgia
| | - Mary Alice Smith
- Interdisciplinary Toxicology Program, Center for Food Safety, University of Georgia, Athens, Georgia.,Environmental Health Science Department, University of Georgia, Athens, Georgia.,Regenerative Bioscience Center, University of Georgia, Athens, Georgia
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Madjunkov M, Chaudhry S, Ito S. Listeriosis during pregnancy. Arch Gynecol Obstet 2017; 296:143-152. [DOI: 10.1007/s00404-017-4401-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/12/2017] [Indexed: 01/30/2023]
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Allerberger F, Huhulescu S. Pregnancy related listeriosis: treatment and control. Expert Rev Anti Infect Ther 2015; 13:395-403. [DOI: 10.1586/14787210.2015.1003809] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Lee CY, Tsai HC, Kunin CM, Lee SSJ, Wu KS, Chen YS. Emergence of sporadic non-clustered cases of hospital-associated listeriosis among immunocompromised adults in southern Taiwan from 1992 to 2013: effect of precipitating immunosuppressive agents. BMC Infect Dis 2014; 14:145. [PMID: 24641498 PMCID: PMC4003814 DOI: 10.1186/1471-2334-14-145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 03/14/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Sporadic non-clustered hospital-associated listeriosis is an emerging infectious disease in immunocompromised hosts. The current study was designed to determine the impact of long-term and precipitating immunosuppressive agents and underlying diseases on triggering the expression of the disease, and to compare the clinical features and outcome of hospital-associated and community-associated listeriosis. METHODS We reviewed the medical records of all patients with Listeria monocytogenes isolated from sterile body sites at a large medical center in southern Taiwan during 1992-2013. Non-clustered cases were defined as those unrelated to any other in time or place. Multivariable regression analysis was used to determine factors associated with prognosis. RESULTS Thirty-five non-clustered cases of listeriosis were identified. Twelve (34.2%) were hospital-associated, and 23 (65.7%) were community-associated. The 60-day mortality was significantly greater in hospital-associated than in community-associated cases (66.7% vs. 17.4%, p = 0.007). Significantly more hospital-associated than community-associated cases were treated with a precipitating immunosuppressive agent within 4 weeks prior to onset of listeriosis (91.7% vs. 4.3%, respectively p < 0.001). The median period from the start of precipitating immunosuppressive treatment to the onset of listeriosis-related symptoms was 12 days (range, 4-27 days) in 11 of the 12 hospital-associated cases. In the multivariable analysis, APACHE II score >21 (p = 0.04) and receipt of precipitating immunosuppressive therapy (p = 0.02) were independent risk factors for 60-day mortality. CONCLUSIONS Sporadic non-clustered hospital-associated listeriosis needs to be considered in the differential diagnosis of sepsis in immunocompromised patients, particularly in those treated with new or increased doses of immunosuppressive agents.
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Affiliation(s)
- Chun-Yuan Lee
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd., Kaohsiung 813, Taiwan
| | - Hung-Chin Tsai
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd., Kaohsiung 813, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Calvin M Kunin
- Department of Internal Medicine (CMK), Ohio State University, Columbus, Ohio and the University of Arizona, Tucson, Arizona, USA
| | - Susan Shin-Jung Lee
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd., Kaohsiung 813, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Sheng Wu
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd., Kaohsiung 813, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yao-Shen Chen
- Division of Infectious Diseases, Department of Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd., Kaohsiung 813, Taiwan
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Graduate Institute of Science Education and Environmental Education, National Kaohsiung Normal University, Kaohsiung, Taiwan
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Zeldovich VB, Clausen CH, Bradford E, Fletcher DA, Maltepe E, Robbins JR, Bakardjiev AI. Placental syncytium forms a biophysical barrier against pathogen invasion. PLoS Pathog 2013; 9:e1003821. [PMID: 24348256 PMCID: PMC3861541 DOI: 10.1371/journal.ppat.1003821] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 10/11/2013] [Indexed: 02/02/2023] Open
Abstract
Fetal syncytiotrophoblasts form a unique fused multinuclear surface that is bathed in maternal blood, and constitutes the main interface between fetus and mother. Syncytiotrophoblasts are exposed to pathogens circulating in maternal blood, and appear to have unique resistance mechanisms against microbial invasion. These are due in part to the lack of intercellular junctions and their receptors, the Achilles heel of polarized mononuclear epithelia. However, the syncytium is immune to receptor-independent invasion as well, suggesting additional general defense mechanisms against infection. The difficulty of maintaining and manipulating primary human syncytiotrophoblasts in culture makes it challenging to investigate the cellular and molecular basis of host defenses in this unique tissue. Here we present a novel system to study placental pathogenesis using murine trophoblast stem cells (mTSC) that can be differentiated into syncytiotrophoblasts and recapitulate human placental syncytium. Consistent with previous results in primary human organ cultures, murine syncytiotrophoblasts were found to be resistant to infection with Listeria monocytogenes via direct invasion and cell-to-cell spread. Atomic force microscopy of murine syncytiotrophoblasts demonstrated that these cells have a greater elastic modulus than mononuclear trophoblasts. Disruption of the unusually dense actin structure--a diffuse meshwork of microfilaments--with Cytochalasin D led to a decrease in its elastic modulus by 25%. This correlated with a small but significant increase in invasion of L. monocytogenes into murine and human syncytium. These results suggest that the syncytial actin cytoskeleton may form a general barrier against pathogen entry in humans and mice. Moreover, murine TSCs are a genetically tractable model system for the investigation of specific pathways in syncytial host defenses.
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Affiliation(s)
- Varvara B. Zeldovich
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America
- Program in Microbial Pathogenesis and Host Defense, University of California, San Francisco, San Francisco, California, United States of America
| | - Casper H. Clausen
- Department of Bioengineering and Program in Biophysics, University of California, Berkeley, Berkeley, California, United States of America
| | - Emily Bradford
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America
- Program in Microbial Pathogenesis and Host Defense, University of California, San Francisco, San Francisco, California, United States of America
- Biomedical Sciences Program, University of California, San Francisco, San Francisco, California, United States of America
| | - Daniel A. Fletcher
- Department of Bioengineering and Program in Biophysics, University of California, Berkeley, Berkeley, California, United States of America
| | - Emin Maltepe
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America
- Biomedical Sciences Program, University of California, San Francisco, San Francisco, California, United States of America
| | - Jennifer R. Robbins
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America
- Program in Microbial Pathogenesis and Host Defense, University of California, San Francisco, San Francisco, California, United States of America
- Department of Biology, Xavier University, Cincinnati, Ohio, United States of America
| | - Anna I. Bakardjiev
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, United States of America
- Program in Microbial Pathogenesis and Host Defense, University of California, San Francisco, San Francisco, California, United States of America
- Biomedical Sciences Program, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
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Wang HL, Ghanem KG, Wang P, Yang S, Li TS. Listeriosis at a tertiary care hospital in beijing, china: high prevalence of nonclustered healthcare-associated cases among adult patients. Clin Infect Dis 2012; 56:666-76. [PMID: 23175565 PMCID: PMC3563391 DOI: 10.1093/cid/cis943] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Thirty-eight cases of listeriosis over a 12-year period from inpatients at a tertiary care hospital in China were reviewed. We found a high prevalence of healthcare-associated cases that did not cluster in time and space. Background. Listeriosis is an emerging infectious disease associated with high mortality. There are few published reports from East Asia and developing countries. Our goal was to describe the clinical characteristics and outcomes of patients diagnosed with Listeria monocytogenes at a tertiary care hospital in Beijing, China. Methods. Peking Union Medical College Hospital (PUMCH), an 1800-bed hospital, consists of 2 campuses that house different medical departments. We retrospectively reviewed all culture-proven cases of listeriosis occurring at PUMCH between 1999 and 2011. Point estimates and 95% confidence intervals are presented. Results. There were 38 patients with listeriosis: 5 neonatal, 8 maternal, and 25 nonmaternal. The median age of the adult nonmaternal patients was 47 (range, 18–79) years with a female predominance (72%). Forty percent (n = 10) had an underlying rheumatic disease. Forty-four percent of cases (n = 11) were healthcare-associated infections occurring a median of 20 (range, 3–44) days after hospital admission. Only 2 of the 11 healthcare-associated cases clustered in space and time. One healthcare-associated case occurred in a patient receiving KHI-272 therapy, an oral, irreversible dual EGFR/HER2 inhibitor. The neonatal and maternal listeriosis cases were similar to those reported in the literature. Conclusions. Nonclustered healthcare-associated cases of L. monocytogenes occurred at a large tertiary care hospital in Beijing, China. The source of these infections is unclear. Although rare, in the setting of immunosuppression, Listeria should be considered in the differential diagnosis of healthcare-associated infections, even in the absence of a point-source outbreak.
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Affiliation(s)
- Huan-Ling Wang
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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The infant skin barrier: can we preserve, protect, and enhance the barrier? Dermatol Res Pract 2012; 2012:198789. [PMID: 22988452 PMCID: PMC3439947 DOI: 10.1155/2012/198789] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 06/15/2012] [Indexed: 12/16/2022] Open
Abstract
Infant skin is different from adult in structure, function, and composition. Despite these differences, the skin barrier is competent at birth in healthy, full-term neonates. The primary focus of this paper is on the developing skin barrier in healthy, full-term neonates and infants. Additionally, a brief discussion of the properties of the skin barrier in premature neonates and infants with abnormal skin conditions (i.e., atopic dermatitis and eczema) is included. As infant skin continues to mature through the first years of life, it is important that skin care products (e.g., cleansers and emollients) are formulated appropriately. Ideally, products that are used on infants should not interfere with skin surface pH or perturb the skin barrier. For cleansers, this can be achieved by choosing the right type of surfactant, by blending surfactants, or by blending hydrophobically-modified polymers (HMPs) with surfactants to increase product mildness. Similarly, choosing the right type of oil for emollients is important. Unlike some vegetable oils, mineral oil is more stable and is not subject to oxidation and hydrolysis. Although emollients can improve the skin barrier, more studies are needed to determine the potential long-term benefits of using emollients on healthy, full-term neonates and infants.
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Tortajada C, Porta R, Riba M, Santoma MJ, Palacín E, Español M. [Nosocomial outbreak due to Listeria monocytogenes in a neonatal unit]. Enferm Infecc Microbiol Clin 2012; 30:143-6. [PMID: 22284133 DOI: 10.1016/j.eimc.2011.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 07/25/2011] [Accepted: 07/31/2011] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Description of an outbreak of Listeria monocytogenes in a neonatal intensive care unit. METHODS A questionnaire, environmental investigation and molecular study were performed. RESULTS We identified a nosocomial outbreak of L. monocytogenes, confirmed by the genetic study, in a neonatal intensive care unit. Three infants were affected. Although the transmission mechanism could not be elucidated, cross-infection was strongly suggested. CONCLUSION Adherence to universal hygiene standards is necessary to avoid nosocomial outbreaks.
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Affiliation(s)
- Cecilia Tortajada
- Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, CIBER de Epidemiologia y Salud Pública (CIBERESP), Barcelona, España.
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How can the microbiologist help in diagnosing neonatal sepsis? Int J Pediatr 2012; 2012:120139. [PMID: 22319539 PMCID: PMC3272815 DOI: 10.1155/2012/120139] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 09/15/2011] [Accepted: 11/29/2011] [Indexed: 01/23/2023] Open
Abstract
Neonatal sepsis can be classified into two subtypes depending upon whether the onset of symptoms is before 72 hours of life (early-onset neonatal sepsis—EONS) or later (late-onset neonatal sepsis—LONS). These definitions have contributed greatly to diagnosis and treatment by identifying which microorganisms are likely to be responsible for sepsis during these periods and the expected outcomes of infection. This paper focuses on the tools that microbiologist can offer to diagnose and eventually prevent neonatal sepsis. Here, we discuss the advantages and limitation of the blood culture, the actual gold standard for sepsis diagnosis. In addition, we examine the utility of molecular techniques in the diagnosis and management of neonatal sepsis.
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[Nosocomially transmitted neonatal Listeriosis]. Enferm Infecc Microbiol Clin 2012; 30:115-6. [PMID: 22244531 DOI: 10.1016/j.eimc.2011.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 11/15/2011] [Indexed: 11/20/2022]
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Potential nosocomial acquisition of epidemic Listeria monocytogenes presenting as multiple brain abscesses resembling nocardiosis. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2011; 21:57-60. [PMID: 21358887 DOI: 10.1155/2010/812648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Listerial brain abscesses are rare, and are found mostly in patients with underlying hematological malignancies or solid-organ transplants. A case of a patient with Crohn's disease and multiple brain abscesses involving the left cerebellum and right sylvian fissure is described. The Gram stain and histopathology of the cerebellar abscess revealed Gram-positive, beaded rods suggestive of Nocardia. However, on culture, Listeria monocytogenes was identified. Listeria may appear Gram-variable and has been misidentified as streptococci, enterococci and diphtheroids. The present case is the first reported case of L monocytogenes resembling Nocardia on both microbiological and histopathological assessment. Reported cases of listerial brain abscesses are sporadic, while the current case was part of a nationwide listerial outbreak linked to consumption of contaminated deli meats. Broad antimicrobial therapy (including antilisterial coverage) in immunosuppressed patients presenting with brain abscess is crucial, until cultures confirm the identification of the organism.
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Lamont RF, Sobel J, Mazaki-Tovi S, Kusanovic JP, Vaisbuch E, Kim SK, Uldbjerg N, Romero R. Listeriosis in human pregnancy: a systematic review. J Perinat Med 2011; 39:227-36. [PMID: 21517700 PMCID: PMC3593057 DOI: 10.1515/jpm.2011.035] [Citation(s) in RCA: 215] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Listeria is commonly found in processed and prepared foods and listeriosis is associated with high morbidity and mortality. Preventative measures are well prescribed and monitoring and voluntary recall of contaminated products has resulted in a 44% reduction in the prevalence of perinatal listeriosis in the USA. Pregnant women are at high risk for listeriosis, but symptoms are non-specific and diagnosis is difficult. The intracellular life-cycle of Listeria protects the bacterium from host innate and adaptive immune responses. Antibiotic treatment requires agents able to penetrate, distribute, and remain stable within host cells. Prolonged use of high-dose ampicillin can significantly improve neonatal outcome.
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Affiliation(s)
- Ronald F. Lamont
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Wayne State University School of Medicine, Department of Obstetrics and Gynecology, Detroit, Michigan, USA
| | - Jack Sobel
- Wayne State University School of Medicine, Department of Infectious Diseases, Detroit, Michigan, USA
| | - Shali Mazaki-Tovi
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Wayne State University School of Medicine, Department of Obstetrics and Gynecology, Detroit, Michigan, USA
| | - Juan Pedro Kusanovic
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Wayne State University School of Medicine, Department of Obstetrics and Gynecology, Detroit, Michigan, USA
| | - Edi Vaisbuch
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Wayne State University School of Medicine, Department of Obstetrics and Gynecology, Detroit, Michigan, USA
| | - Sun Kwon Kim
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
| | - Niels Uldbjerg
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
| | - Roberto Romero
- Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA
- Wayne State University School of Medicine, Department of Obstetrics and Gynecology, Detroit, Michigan, USA
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan, USA
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A large outbreak of Listeria monocytogenes infection with short incubation period in a tertiary care hospital. J Infect 2010; 61:465-70. [PMID: 20813130 DOI: 10.1016/j.jinf.2010.08.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 08/19/2010] [Accepted: 08/23/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Listeria monocytogenes is a foodborne pathogen with a high mortality rate. We report a large, nosocomial outbreak of Listeria monocytogenes infection. METHODS Patients with L. monocytogenes isolated from a sterile site, or from faeces when diarrhoea and fever were present, were included. Clinical data were collected from the patient records. The incubation period was calculated as the time between exposure and start of symptoms. RESULTS Seventeen patients (11 women, median age 64 years) were infected of whom 15 patients were at increased risk for listeriosis. Eleven patients received empiric antibiotic treatment, eight of them with cephalosporins. Three patients died with a resulting mortality rate of 18%. The source of the outbreak was a Camembert cheese made from pasteurised milk containing up to 360 million colony forming units per portion. The median incubation period was 3-4 days. CONCLUSIONS The incubation period in this outbreak was significantly shorter than previously reported, a fact that may be due to the high number of ingested bacteria. Furthermore, food restrictions in hospitals seem warranted, as do treatment with antibiotics effective against L. monocytogenes in at-risk populations.
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25
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Abstract
Infection by Listeria monocytogenes in pregnant women may result in fetal loss or invasive disease in the newborn. We examined listeriosis cases reported through the U.S. Listeria Initiative during 2004-2007. Cases were classified as pregnancy-associated if illness occurred in a pregnant woman or an infant aged <28 days. Of 758 reported Listeria cases, 128 (16.9%) were pregnancy-associated. Maternal infection resulted in four neonatal deaths and 26 (20.3%) fetal losses. Invasive illnesses in newborns (n=85) were meningitis (32.9%) and sepsis (36.5%). Pregnant women with Listeria were more likely to report Hispanic ethnicity (52.8% vs. 25.6%, respectively; OR 3.3 95% CI 2.2-4.8) than mothers giving live birth in the USA during 2005 and were more likely to report consumption of Mexican-style cheese (OR 2.6, 95% CI 1.6-4.2) than were non-pregnant patients with Listeria infection. Pregnant woman comprised a considerable proportion of reported listeriosis cases. Further declines in pregnancy-associated listeriosis will require education about avoiding high-risk foods, and continued regulatory and industry efforts to decrease Listeria in foods.
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Abstract
Listeria monocytogenes, a small, facultative anaerobic, Gram-positive motile bacillus, is an important cause of foodborne illness which disproportionately affects pregnant women and their newborns. Listeria infects many types of animals and contaminates numerous foods including vegetables, milk, chicken and beef. This organism has a unique proclivity to infect the fetoplacental unit with the ability to invade cells, multiply intracellularly and be transmitted cell-to-cell. The organism possesses several virulence factors, including internalin A and internalin B, which facilitate the direct invasion of cells. Cell-to-cell transmission is promoted by the bacterial surface protein ActA which is regulated by a transcriptional activator known as positive regulatory factor A. Both innate and adaptive immune responses enable the host to eliminate this pathogen. Clinical manifestations of infection in the newborn fall into the traditional categories of early- and late-onset sepsis. Therapeutic recommendations include ampicillin and gentamicin for 14-21 days.
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Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am J Infect Control 2007; 35:S65-164. [PMID: 18068815 PMCID: PMC7119119 DOI: 10.1016/j.ajic.2007.10.007] [Citation(s) in RCA: 1615] [Impact Index Per Article: 95.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Vonberg RP, Gastmeier P. Hospital-acquired infections related to contaminated substances. J Hosp Infect 2006; 65:15-23. [PMID: 17145102 DOI: 10.1016/j.jhin.2006.09.018] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Accepted: 09/15/2006] [Indexed: 11/30/2022]
Abstract
Drug-related outbreaks are frequently reported from various medical departments. A systematic review was performed to describe characteristics of these outbreaks and to determine the most frequent occasions in which contamination of substances for patient care take place. Articles were assessed by a search of the outbreak database, a search of PubMed, and hand search of reference lists from relevant articles. Articles published before 1990 were excluded. Data on affected patients, hospital-acquired infections, substances, pathogens and graded information about the location of the contamination incidence were extracted. A total of 2250 patients in 128 articles were included, mostly from intensive care units or haematological departments. Septicaemia was the most frequent hospital-acquired infection. Most often articles report contamination of blood products and heparin-sodium chloride solutions. The most frequent pathogens were hepatitis A virus, Yersinia enterocolitica, and Serratia spp. for blood products and Burkholderia cepacia and Enterobacter spp. for substances other than blood products. Mortality was highest if red blood cells or total parenteral nutrition formulas were contaminated. In 64 of the outbreaks multi-dose vials had been used against the manufacturers' recommendations. Thus, drug-related outbreaks are likely to occur particularly when basic hygiene measures are disobeyed. A large proportion of drug-related nosocomial infections could have been prevented, for example, by avoiding the use of multi-dose vials.
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Affiliation(s)
- R-P Vonberg
- Institute for Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany.
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30
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Kaufman D, Fairchild KD. Clinical microbiology of bacterial and fungal sepsis in very-low-birth-weight infants. Clin Microbiol Rev 2004; 17:638-80, table of contents. [PMID: 15258097 PMCID: PMC452555 DOI: 10.1128/cmr.17.3.638-680.2004] [Citation(s) in RCA: 288] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Twenty percent of very-low-birth-weight (<1500 g) preterm infants experience a serious systemic infection, and despite advances in neonatal intensive care and antimicrobials, mortality is as much as threefold higher for these infants who develop sepsis than their counterparts without sepsis during their hospitalization. Outcomes may be improved by preventative strategies, earlier and accurate diagnosis, and adjunct therapies to combat infection and protect the vulnerable preterm infant during an infection. Earlier diagnosis on the basis of factors such as abnormal heart rate characteristics may offer the ability to initiate treatment prior to the onset of clinical symptoms. Molecular and adjunctive diagnostics may also aid in diagnosing invasive infection when clinical symptoms indicate infection but no organisms are isolated in culture. Due to the high morbidity and mortality, preventative and adjunctive therapies are needed. Prophylaxis has been effective in preventing early-onset group B streptococcal sepsis and late-onset Candida sepsis. Future research in prophylaxis using active and passive immunization strategies offers prevention without the risk of resistance to antimicrobials. Identification of the differences in neonatal intensive care units with low and high infection rates and implementation of infection control measures remain paramount in each neonatal intensive care unit caring for preterm infants.
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Affiliation(s)
- David Kaufman
- Department of Pediatrics, Division of Neonatology, P.O. Box 800386, University of Virginia Health System, 3768 Old Medical School, Hospital Drive, Charlottesville, VA 22908, USA.
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33
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Abstract
Listeria monocytogenes is a gram-positive bacillus that causes meningitis, encephalitis, bacteremia, and febrile gastroenteritis. Most disease occurs in immunosuppressed individuals. Recent seroepidemiologic studies show that the infection is foodborne. Due to the increasing number of immunosuppressed individuals at risk for listeriosis, as well as the persistence of substantial foodborne outbreaks, L. monocytogenes has gained worldwide attention as an important pathogen. Heightened surveillance and quality control by the food industry have been instituted, leading to a reduction in the number of cases and deaths from this infection in the past decade. However, due to the ubiquity of the organism in the environment, outbreaks and sporadic disease continue to occur. The standard therapy for listeriosis is a combination of ampicillin and gentamicin or, for patients who are intolerant of b-lactam agents, trimethoprim-sulfamethazole. Despite the availability of therapy, the mortality rate remains high in those with T-cell immunodeficiencies.
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Affiliation(s)
- Nancy F Crum
- Infectious Disease Division, Naval Medical Center, 34800 Bob Wilson Drive, San Diego, CA, 92134, USA.
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35
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Transmission, Pathogenesis, and Epidemiology of Listeria Monocytogenes. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2001. [DOI: 10.1097/00019048-200101000-00008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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36
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Abstract
Listeria monocytogenes emerged as an important foodborne pathogen in the latter part of the 20th century. Clinical syndromes caused by this microorganism include sepsis in the immunocompromised patient, meningoencephalitis in infants and adults, and febrile gastroenteritis. Focal infections at other sites are less frequent. Listeria species are commonly found in raw and unprocessed food products. Major outbreaks of listeriosis, with high morbidity and mortality, have been caused by a variety of foods, including soft cheeses, delicatessen meats, and vegetable products. Improved detection methods, dietary recommendations, and, in some cases, preemptive antibiotic treatment or prophylaxis have reduced the incidence of sporadic listeriosis infections in the United States. Microbial virulence factors distinguishing environmental strains of L. monocytogenes from invasive strains causing foodborne illness and host factors promoting human infection remain incompletely understood.
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Affiliation(s)
- W F Schlech
- Division of Infectious Diseases, Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada.
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37
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Wilkins PA, Marsh PS, Acland H, Del Piero F. Listeria monocytogenes septicemia in a Thoroughbred foal. J Vet Diagn Invest 2000; 12:173-6. [PMID: 10730952 DOI: 10.1177/104063870001200216] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Listeria monocytogenes septicemia was diagnosed in a 6-day-old Thoroughbred foal. Primary clinical signs included fever, depression, diarrhea, and respiratory distress. Hematologic abnormalities included leukopenia, neutropenia, degenerative left shift, and hyperfibrinogenemia. Clinical chemistry and blood gas abnormalities included metabolic acidosis, hypoxemia, hypocapnia, hypoglycemia, and hyponatremia. Despite aggressive therapeutic intervention and intensive care, the foal died within 12 hours of admission. A postmortem examination was performed, and the primary gross lesion was bilaterally severe, focally extensive bronchopneumonia. Histopathology revealed severe subacute multifocal suppurative bronchopneumonia with necrotizing vasculitis and intralesional coccobacilli. Cultures of blood collected at admission and immediately prior to death were positive for L. monocytogenes, as were cultures obtained from lung and liver at necropsy. Immunohistochemical examination of formalin-fixed tissues revealed abundant intra- and extracellular L. monocytogenes antigen within the lung and intravascularly in multiple organs.
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Affiliation(s)
- P A Wilkins
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square 19348, USA
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39
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Mead PS, Slutsker L, Dietz V, McCaig LF, Bresee JS, Shapiro C, Griffin PM, Tauxe RV. Food-related illness and death in the United States. Emerg Infect Dis 1999; 5:607-25. [PMID: 10511517 PMCID: PMC2627714 DOI: 10.3201/eid0505.990502] [Citation(s) in RCA: 4032] [Impact Index Per Article: 161.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
To better quantify the impact of foodborne diseases on health in the United States, we compiled and analyzed information from multiple surveillance systems and other sources. We estimate that foodborne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year. Known pathogens account for an estimated 14 million illnesses, 60, 000 hospitalizations, and 1,800 deaths. Three pathogens, Salmonella, Listeria, and Toxoplasma, are responsible for 1,500 deaths each year, more than 75% of those caused by known pathogens, while unknown agents account for the remaining 62 million illnesses, 265,000 hospitalizations, and 3,200 deaths. Overall, foodborne diseases appear to cause more illnesses but fewer deaths than previously estimated.
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Affiliation(s)
- P S Mead
- Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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40
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Affiliation(s)
- J. McLauchlin
- Food Hygiene Laboratory, PHLS Central Public Health Laboratory, London, UK
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41
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Elsner HA, Tenschert W, Fischer L, Kaulfers PM. Nosocomial infections by Listeria monocytogenes: analysis of a cluster of septicemias in immunocompromised patients. Infection 1997; 25:135-9. [PMID: 9181378 DOI: 10.1007/bf02113599] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
From December 1994 to November 1995 an unusual accumulation of Listeria infections occurred at the University Hospital Hamburg-Eppendorf, Germany. Eleven immunosuppressed patients from different departments developed septicemia due to Listeria monocytogenes during hospitalization. In a retrospective study, serotyping and pulsed-field gel electrophoresis revealed that six isolates were identical or genetically related. Four of them had been isolated from renal transplant recipients. Listeria monocytogenes was neither detected in food samples of the renal transplantation ward, nor in stool specimens obtained from the ward staff. There had been no close contacts among the infected patients. Before transplantation, the renal transplant recipients had been dialysed in different dialysis centers. Nosocomial foodborne transmission could not be proven but seems likely.
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Affiliation(s)
- H A Elsner
- Institut für Medizinische Mikrobiologie und Immunologie, Universitätskrankenhaus Hamburg-Eppendorf, Germany
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42
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43
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Aujard Y, Bedu A, Mariani-Kurkdjian P, Baumann C, Boissinot C. Infections néonatales à Listeria monocytogenes : à propos de 12 cas. Med Mal Infect 1995. [DOI: 10.1016/s0399-077x(05)81062-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Torensma R, Visser MJ, Aarsman CJ, Poppelier MJ, Fluit AC, Verhoef J. Monoclonal antibodies that react with live Listeria spp. Appl Environ Microbiol 1993; 59:2713-6. [PMID: 8368856 PMCID: PMC182343 DOI: 10.1128/aem.59.8.2713-2716.1993] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Seven monoclonal antibodies (MAbs) against Listeria spp. that were reactive with live Listeria spp. were developed. Two of these MAbs (55-8 and 55-37) were members of the immunoglobulin M class, and all other MAbs were members of the immunoglobulin G class. MAb 55-23 reacted with 148 of 157 strains tested. MAb 34-51 reacted with serotype 1/2a, 1/2b, and 1/2c strains and exhibited a scattered reaction pattern with strains belonging to other serotypes. MAb 55-44 reacted with all of the strains belonging to serotype 4b tested. MAb 55-4 reacted with all of the serotype 1/2a isolates tested, although reactivity with other isolates also was observed. The other MAbs exhibited scattered reaction patterns. No correlation of reactivity pattern with serotype was found. Marked differences were observed between the reactivities of MAbs as determined by a magnetic immunoluminescence assay and a whole-cell enzyme-linked immunosorbent assay. Only MAb 55-23 exhibited minor reactivity with three Streptococcus spp. isolates, while no reactivity was observed with six Bacillus spp. strains, one Escherichia coli strain, and one Citrobacter sp. strain. In Western blots (immunoblots) MAbs 55-23, 55-44, and 34-9 exhibited reactivity; all other MAbs were negative in this assay.
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Affiliation(s)
- R Torensma
- Eijkman-Winkler Laboratory for Medical Microbiology, University Hospital Utrecht, The Netherlands
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45
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Schlech WF. Lowbury Lecture. Listeriosis: epidemiology, virulence and the significance of contaminated foodstuffs. J Hosp Infect 1991; 19:211-24. [PMID: 1686033 DOI: 10.1016/0195-6701(91)90238-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Recent epidemiological evidence confirms that sporadic, as well as outbreak-associated, cases of listeriosis are primarily foodborne in origin. Implicated foodstuffs include meat products, dairy products, fruit, seafood and raw and processed vegetables. Large community-acquired outbreaks in North America and Europe have been complemented by smaller outbreaks involving hospitalized patients. Anecdotal reports and case clusters of nosocomial cases also support foodborne transmission. Cross-infection may be a major mode of transmission as demonstrated in a recent outbreak in Costa Rica. The sporadic nature of outbreaks of listeriosis are more consistent with changes in organism virulence rather than host susceptibility. The population of patients at risk for listeriosis (pregnant women and immunocompromised hosts) may not vary greatly. Establishment of infection is probably dose-dependent and gastric acidity may be protective. However, other organism-specific virulence factors, such as haemolysin production, may affect the post-intestinal phase of infection. Virulence factors other than haemolysins have not been characterized as yet. In summary, acquisition of Listeria monocytogenes infection from the environment by susceptible hosts may be widespread but invasive infection remains rare and the determinants of invasion require further elucidation.
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Affiliation(s)
- W F Schlech
- Department of Medicine, Dalhousie University
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Abstract
The gram-positive bacterium Listeria monocytogenes is an ubiquitous, intracellular pathogen which has been implicated within the past decade as the causative organism in several outbreaks of foodborne disease. Listeriosis, with a mortality rate of about 24%, is found mainly among pregnant women, their fetuses, and immunocompromised persons, with symptoms of abortion, neonatal death, septicemia, and meningitis. Epidemiological investigations can make use of strain-typing procedures such as DNA restriction enzyme analysis or electrophoretic enzyme typing. The organism has a multifactorial virulence system, with the thiol-activated hemolysin, listeriolysin O, being identified as playing a crucial role in the organism's ability to multiply within host phagocytic cells and to spread from cell to cell. The organism occurs widely in food, with the highest incidences being found in meat, poultry, and seafood products. Improved methods for detecting and enumerating the organism in foodstuffs are now available, including those based on the use of monoclonal antibodies, DNA probes, or the polymerase chain reaction. As knowledge of the molecular and applied biology of L. monocytogenes increases, progress can be made in the prevention and control of human infection.
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Affiliation(s)
- J M Farber
- Bureau of Microbial Hazards, Food Directorate, Ottawa, Ontario, Canada
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