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Listeriosis 

Listeriosis
Chapter:
Listeriosis
DOI:
10.1093/med/9780198729228.003.0085
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date: 26 June 2019

Listeriosis is a severe, but relatively rare, infection in the general population, and it affects primarily pregnant women, unborn and newly delivered infants, the immunocompromised, and the elderly. Almost all cases of human listeriosis are due to Listeria monocytogenes. Alimentary transmission is the commonest route of acquisition. Microbiological and epidemiological evidence supports an association with many food types (dairy, meat, vegetable, fish and shellfish, sandwiches) in both sporadic and epidemic listeriosis. Maternal infection is associated with abortion, preterm delivery, and fetal death. Neonatal listeriosis can be early-onset with a sepsis-like picture in the first day or two of life, or late-onset, more commonly presenting with meningitis at around 1–2 weeks of age. Listeriosis in children older than 1 month is very rare, except in those with underlying disease. The organisms can be recovered on blood agar media from cultures of blood, cerebrospinal fluid, meconium, amniotic fluid, placenta, gastric washings, placental tissue, and other infected tissue specimens, including joint, pleural, or pericardial fluid. Intravenous ampicillin and amoxicillin are the mainstay of treatment, although high drug concentrations are required for bactericidal effects. Recommendations for prevention of listeriosis include washing of raw vegetables, avoidance of unpasteurized dairy products, thorough cooking of raw food, and washing of hands, knives, and cutting boards after exposure to uncooked foods. Future research should focus on a better understanding of L. monocytogenes immunological aspects and risk factors for acquisition, as well as on the discovery of new drugs with a better activity against these bacteria.

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