CLINICAL CASE OF ADVERSE OUTCOME OF NEONATAL LYSTERIOSIS

A clinical case of neonatal listeriosis with an unfavorable outcome is presented. The first symptoms of the disease in a newborn appeared on the 3rd day, intrauterine infection was suspected on the 5th day. A evolving clinical picture with death on day 9 is described. The issues of the ongoing antibiotic therapy are discussed. The diagnosis of neonatal listeriosis was confirmed by the results of postmortem and morphological examination of the deceased newborn. The cause of his death was an early form of listeria infection (septicemia) with damage mainly to the lungs and liver. Specialists who provide care for pregnant women, newborns and children should be alert for listeria infection.

Isolation, Identification and Antibiotic Susceptibility Patterns of Listeria Monocytogens from Pregnant Women

IntroductionThe present study is made to determine the prevalence rate, isolation, identification and antibioticsusceptibility pattern of L. monocytogens isolated from pregnant women. This research not onlyguides to the clinician for treatment but also help laboratory worker to monitor susceptibilitypattern among the Listeria species. MethodsThe samples were collected from Gynecology department from January 2017 to December 2019and processed in the Department of Microbiology at College of Medical Sciences, Bharatpur Nepal.Two hundred thirty four antenatal mothers having age between 17 and 39 years of gestation periodbetween 7th weeks and 36th weeks patient with a flue like sign and symptoms were screened forL. monocytogens. Bacterial isolation identification and antibiotic sensitivity tests were done as perstandard microbiological guidelines. ResultsIn this present research, the prevalence of L. monocytogens was found 39/234 (16.7%), where high rate of Listeria infection was found 21(53.1%) among the patients of age between 25 and 32 who were mostly from urban area. We found eating meat 38(97.4%) and fish 39(100.0%), non-pasteurized simple boiled milk 39(100.0%) and vegetables like salad eater 32(82.1%) has highest rate of listeriosis. The results showed most of the listeriosis were occurring in a 3rd trimester 17(43.6%) compared with the 2nd and 1st trimester. Overall, the antibiotics resistance pattern found low in L. monocytogens. This investigation also showed less resistance in erythromycin 9(23.1%), ciprofloxacin 8(20.5%), chloramphenicol 16(41.1%). The increased resistance pattern among Listeria species were found in penicillin 31(79.5%), cotrimoxazole 20(51.3%), amoxicillin 21(55.1%) and vancomycin 29(74.4%). ConclusionsIt is very important to consider listeriosis in a clinical practice now a day. Maternal Listeriosis shouldbe considered in all age group of pregnant women. Regular surveillance of antibiotic susceptibility test is very much important for clinician to select best medicine to treat different cases of listeriosis.

Listeria infection in young infants: results from a national surveillance study in the UK and Ireland

ObjectivesTo describe the epidemiology, age at infection, clinical characteristics and outcome of listeria infection in young infants to inform management and empiric antibiotic choice in young infants.DesignProspective 2-year surveillance of Listeria monocytogenes infection in young infants detected through the British Paediatric Surveillance Unit ‘orange card’ system and triangulated with the public health laboratories.SettingNational population study (England, Wales, Scotland and the Ireland)PatientsAll infants under 90 days with proven or probable invasive listeriosisMain outcome measuresIncidence, mortality, age of infection, clinical characteristics and outcomeResultsDuring a 2-year period (2017–2019), 27 cases of listeriosis in infants <90 days of age were reported. The incidence of listeriosis in this study was 1.8 per 100 000 live births with 7% mortality (2/27). Nearly all cases presented within the first 24 hours of life (26/27). The majority (20/27, 74%) were born preterm and 16/24 (67%) were born to women from ethnic minority backgrounds.ConclusionsInvasive listeriosis in young infants in the UK and Ireland is rare and presents early in the neonatal period. National guidelines that recommend the use of amoxicillin as part of empiric regimes for sepsis and meningitis in infants over 1 month of age should be modified.

Rhombencephalitis due to Listeria monocytogenes infection with GQ1b antibody positivity and multiple intracranial hemorrhage: a case report and literature review

Listeria monocytogenes is a Gram-positive facultative intracellular bacterium that causes central nervous system infection. We report a case of rhombencephalitis caused by L. monocytogenes infection, which mimicked Bickerstaff’s brainstem encephalitis, and GQ1b antibody positivity and multiple intracranial foci were observed. A 68-year-old male patient presented with a nonspecific prodrome of faintness, forehead tightness, and walking instability. This was followed by progressive cranial nerve palsies, limb weakness, cerebellar signs, hyperpyrexia, and impaired consciousness. Brain imaging showed multiple abnormal brainstem and cerebellar signals that were accompanied by blood infiltration without any lesion enhancement. Serum GQ1b antibody positivity led to an initial diagnosis of Bickerstaff’s brainstem encephalitis, which was treated with immunosuppressive therapy with limited efficacy. A pathogen examination helped confirm L. monocytogenes infection. A combination of meropenem and trimethoprim-sulfamethoxazole therapy was applied and the patient recovered without sequelae. The symptoms and imaging of Listeria rhombencephalitis are nonspecific. Accurate diagnosis and prompt treatment of this condition are essential. Whether Listeria infection triggers an autoimmune response remains unclear.

Analysis of sporadic cases of invasive listeriosis in a metropolis

Introduction. Listeriosis is a foodborne infection, especially dangerous for people in at-risk groups. Susceptibility to listeria infection is determined by a complex of reasons: environmental factors, host immune status, and pathogen virulence. The susceptibility to listeriosis can also be aggravated by previous infections, especially viral infections, which demonstrate a steadily increasing number of identified pathogens.The aim of our study was to present molecular and genetic characterization of pathogens causing sporadic invasive listeriosis in a megalopolis, primarily during the peak of influenza and ARVI incidence.Materials and methods. Listeria monocytogenes isolates were collected from 18 hospitalized patients at hospitals in Moscow, from November 2018 to October 2019. The first comparison group was represented by isolates from food products and fish preserves. The second comparison group included previously examined environmental isolates. The clinical isolates were examined by using multilocus sequence typing techniques, including the standard MLST scheme extended by loci of internalin genes. Isolates of the autochthonous genotype (ST7) were compared through whole-genome sequencing and subsequent analysis of the core genome (cgMLST).Results. In cases of invasive listeriosis, 44% of isolates were isolated from patients with listeriosis; 27% of isolates were obtained from patients with meningitis. L. monocytogenes of phylogenetic lineage II prevailed in these groups of cases that occurred when the epidemic threshold for influenza was crossed during the 2018/2019 season. Listeria pneumonia identified in the senior age group occurred during the season of autumn ARVI and was primarily caused by L. monocytogenes of phylogenetic lineage I. The examination of genomes of ST7 isolates demonstrated identity between the core genomes of bacteria isolated from the mother-infant pair. Out of ST7 food isolates most closely related to the clinical ones was the isolate from meat (23 locus differences, the common deletion in the MFS transporter locus). Analyzing invasive listeriosis, the comparison between the list of the identified genotypes and the data from European countries showed that each country had its own specific range of genotypes, though ST7 was detected in all the examined samples.Conclusions. Along with the monitoring of food manufacturing and storage, timely vaccination against seasonal respiratory infections and use of personal protective equipment in public spaces can reduce the risk of listeriosis incidence in at-risk groups.

Receptor-targeted engineered probiotics mitigate lethal Listeria infection

Probiotic bacteria reduce the intestinal colonization of pathogens. Yet, their use in preventing fatal infection caused by foodborne Listeria monocytogenes (Lm), is inconsistent. Here, we bioengineered Lactobacillusprobiotics (BLP) to express the Listeria adhesion protein (LAP) from a non-pathogenic Listeria (L. innocua) and a pathogenic Listeria (Lm) on the surface of Lactobacillus casei. The BLP strains colonize the intestine, reduce Lm mucosal colonization and systemic dissemination, and protect mice from lethal infection. The BLP competitively excludes Lm by occupying the surface presented LAP receptor, heat shock protein 60 and ameliorates the Lm-induced intestinal barrier dysfunction by blocking the nuclear factor-κB and myosin light chain kinase-mediated redistribution of the major epithelial junctional proteins. Additionally, the BLP increases intestinal immunomodulatory functions by recruiting FOXP3+T cells, CD11c+ dendritic cells and natural killer cells. Engineering a probiotic strain with an adhesion protein from a non-pathogenic bacterium provides a new paradigm to exclude pathogens and amplify their inherent health benefits.

Intraperitoneal ampicillin treatment for peritoneal dialysis- related peritonitis with Listeria monocytogenes – a case report

Background Peritoneal dialysis (PD)-related peritonitis is a rare but serious complication and is associated with increased morbidity and mortality rates. It is most commonly caused by Staphylococcus aureus or Staphylococcus epidermidis, but infection with Listeria monocytogenes may also occur. Recommendations for antibiotic treatment of a Listeria infection are currently based on a small number of case reports and suggest the administration of ampicillin. But unlike vancomycin or gentamicin, for ampicillin the route of application, the dosage, and the duration of treatment have not yet been established. We report a case in which PD-associated peritonitis due to Listeria infection was treated with ampicillin administered intravenously and intraperitoneally, separately and in combination. Case presentation A 72-year-old man with chronic kidney disease stage 5 dialysis (CKDG5D) secondary to hypertension and diabetes was hospitalised in April 2020 because of PD-related peritonitis caused by a Listeria infection. In accordance with the results of resistance tests, the patient was treated with intravenous ampicillin at a dosage of 6 g twice daily. After initial treatment the leukocyte count in the PD effluent had decreased substantially, but it was permanently reduced only with the addition of intraperitoneal ampicillin (4 g daily). Efficient serum concentrations of ampicillin were determined for both routes of administration, intravenous and intraperitoneal. Conclusion This is the first case report demonstrating that PD-related peritonitis due to Listeria monocytogenes infection can be treated with intraperitoneal ampicillin and monitored by the determination of peripheral serum concentrations of ampicillin.

Listeria myopericarditis associated with right atrial mural thrombus: a case report

Background Pericarditis is a common cardiology presentation, most often due to a viral or idiopathic cause. Listeria as a cause of pericarditis is rare. Listeria is an infection that is readily treatable with antibiotics following accurate identification. Without adequate treatment, Listeria infection has a high mortality rate. Case summary In this case, a fit and well 59-year-old man complained of headaches and fever to the emergency department (ED). He was provisionally diagnosed with giant cell arteritis (GCA) and commenced on management pathways for GCA. He represented to the ED with chest pain and electrocardiogram (ECG) changes suggestive of a clinical presentation of pericarditis. He received treatment for idiopathic pericarditis with no clinical resolution. Cardiac magnetic resonance imaging (MRI) showed myopericardial inflammation associated with a right atrial mural thrombus. After 2 weeks of poor treatment response, peripheral blood cultures grew Listeria monocytogenes and the patient responded well to antibiotic treatment. Repeat cardiac MRI after an extended course of antibiotics showed resolution of MRI signs. Discussion This is a case of Listeria myopericarditis. Physicians should consider rarer causes of myopericarditis in treatment resistance cases. Cardiac MRI has utility in atypical or treatment resistant patients to assess myopericardial inflammation and response to treatment.