Listeria monocytogenes

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Listeria monocytogenes

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A 23-year-old gravida 1 para 0 woman presents to the obstetrics clinic to discuss pregnancy. Based on the first-trimester ultrasound, the patient is in the 20th week of gestation. As part of pregnancy complication counseling, the patient and physician discuss Listeria monocytogenes infection and how the risk of infection can be decreased. Which of the following measures can be taken to decrease the risk of infection with Listeria monocytogenes?  

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Ampicillin

Listeria monocytogenes p. , 137

Gastroenteritis

Listeria monocytogenes p. , 137

Granulomatosis infantiseptica p. NaN

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Immunocompromised patients

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Listeria spp.

catalase-positive organism p. 125

Gram-positive algorithm p. 132

intracellular organism p. 125

meningitis p. 177

taxonomy p. 122

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β -hemolysis p. 133

granulomatous diseases p. NaN

neonates p. 181

penicillins for p. 185

Meningitis

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Neonates

Listeria monocytogenes in p. 137

Pregnancy p. 651

Listeria monocytogenes in p. 137

Septicemia

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Spontaneous abortion

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Transcript

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Listeria monocytogenes or just L. monocytogenes, is a gram-positive bacteria that causes listeriosis. Listeria was discovered by a Scottish doctor, J.H.H. Pirie, who named it in honor of British surgeon Joseph Lister,. It’s also called “monocytogenes” because when it was inoculated in rabbits, their monocyte levels increased.

Ok now, L. monocytogenes is a rod-shaped bacteria with a thick peptidoglycan cell wall. So when gram-stained, it takes in purple dye, making it a gram-positive bacteria. It is catalase positive and oxidase negative - which means it produces the enzyme catalase, but not oxidase. L. monocytogenes is a facultative intracellular pathogen, meaning it can live both outside or inside of its host’s cells. It doesn’t form spores and it is facultatively anaerobic, meaning that it can survive in both aerobic and anaerobic environments.

Now, when L. monocytogenes is cultivated on blood agar medium, its colonies cause beta-hemolysis, also called complete hemolysis. That’s because it produces toxins called beta hemolysins, which hydrolyze the hemoglobin within red blood cells to transparent yellow color byproducts.

L. monocytogenes is a motile bacteria, with a very interesting way to move, that depends on both its location, and the temperature. In an extracellular environment, this bacteria moves by beating its flagella creating a characteristic tumbling motility. But this is only possible at 37 degrees Celsius and below. That’s because FlaA, the gene that codes for flagellin, which is the structural protein that makes up the flagella becomes downregulated as the temperature rises up to 37 degree Celsius. So above 37 degrees, there’s reduced production of flagellin proteins, meaning no flagella being made, rendering L. monocytogenes non-motile.

In an intracellular environment, L. monocytogenes moves by an actin-based motility. It start with this bacteria producing a protein called Actin assembly-inducing protein or just ACTA, which recruits small actin filaments at one end. As more and more actin filaments get recruited and polymerized behind the bacteria’s end pole, that propels the bacteria forward, like a rocket.

L. monocytogenes is a foodborne bacteria, meaning people get infected when they eat contaminated food - especially unpasteurized dairy products and cold deli meats, and this bacteria is known to survive even at very low temperatures in the fridge Once this bacteria gets into the gut, it uses its attachment proteins called internalins to attach to the host’s receptor proteins, such as E cadherin located on goblet cells of the intestinal mucosa. After attaching to the host’s cells, this bacteria is slowly engulfed by the cell membrane, which invaginates to form a sac on its inner side. The sac then separates from the actual cell membrane forming what’s referred to a internalization vacuole.

Summary

Listeria monocytogenes is a gram-positive, rod-shaped, facultatively anaerobic bacterium, which can cause an infection known as listeriosis. Although rare, listeriosis can be deadly in immunosuppressed people, pregnant women, newborns, and the elderly.

Listeriosis presents with low-grade fever, diarrhea, and vomiting. It can complicate into a high-grade fever, liver abscess and jaundice, and altered mental status in case of disseminated listeriosis. Listeriosis is diagnosed using cultures, and imaging studies like a CT scan may help identify liver abscesses. Treatment is with antibiotics, such as ampicillin and gentamicin combined, or just meropenem in those who are allergic to ampicillin.

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