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Listeriosis

Disease Details

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Description: Listeriosis is a serious bacterial infection caused by Listeria monocytogenes, typically contracted through the consumption of contaminated food.
Type: Listeriosis is an infectious disease caused by the bacterium Listeria monocytogenes. It is not generally associated with genetic transmission. Instead, it is typically acquired through the consumption of contaminated food.
Signs And Symptoms: The disease primarily affects older adults, persons with weakened immune systems, pregnant women, and newborns. Rarely, people without these risk factors can also be affected. A person with listeriosis usually has fever and muscle aches, often preceded by diarrhea or other gastrointestinal symptoms. Almost everyone who is diagnosed with listeriosis has invasive infection (meaning that the bacteria spread from their intestines to their bloodstream or other body sites). Disease may occur as much as two months after eating contaminated food.The symptoms vary with the infected person:
High-risk people other than pregnant women: Symptoms can include fever, muscle aches, headache, stiff neck, confusion, loss of balance, and convulsions.
Pregnant women: Pregnant women typically experience only a mild, flu-like illness. However, infections during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn.
Previously healthy people: People who were previously healthy but were exposed to a very large dose of Listeria can develop a non-invasive illness (meaning that the bacteria have not spread into their blood stream or other body sites). Symptoms can include diarrhea and fever.If an animal has eaten food contaminated with Listeria and does not have any symptoms, most experts believe that no tests or treatment are needed, even for people at high risk for listeriosis.
Prognosis: The prognosis for listeriosis varies depending on the patient's age, immune status, and the promptness of treatment. Healthy individuals who receive timely antibiotic treatment generally have a good prognosis. However, in high-risk groups such as neonates, pregnant women, the elderly, and immunocompromised individuals, the prognosis can be more severe and may include complications like meningitis or septicemia, which can be life-threatening. The overall mortality rate for severe cases is relatively high, reflecting the serious nature of this infection.
Onset: The onset of listeriosis symptoms can vary but typically occurs between a few days to 2 months after consuming contaminated food. Early signs include fever, muscle aches, and gastrointestinal symptoms such as nausea or diarrhea. As the infection progresses, it can lead to severe complications, particularly in vulnerable populations such as pregnant women, newborns, the elderly, and individuals with weakened immune systems.
Prevalence: Listeriosis is a relatively rare but serious infection caused by the bacterium Listeria monocytogenes. In developed countries, the prevalence of listeriosis ranges from 2 to 10 cases per 1 million people annually. However, the exact prevalence can vary based on factors such as regional food safety practices and public health measures.
Epidemiology: Incidence in 2004–2005 was 2.5–3 cases per million population a year in the United States, where pregnant women accounted for 30% of all cases.
Of all nonperinatal infections, 70% occur in immunocompromised patients. Incidence in the U.S. has been falling since the 1990s, in contrast to Europe where changes in eating habits have led to an increase during the same time. In the EU, it has stabilized at around 5 cases per annum per million population, although the rate in each country contributing data to EFSA/ECDC varies greatly.There are four distinct clinical syndromes:
Infection in pregnancy: Listeria can proliferate asymptomatically in the vagina and uterus. If the mother becomes symptomatic, it is usually in the third trimester. Symptoms include fever, myalgias, arthralgias and headache. Miscarriage, stillbirth and preterm labor are complications of this infection. Symptoms last 7–10 days.
Neonatal infection (granulomatosis infantiseptica): There are two forms. One, an early-onset sepsis, with Listeria acquired in utero, results in premature birth. Listeria can be isolated in the placenta, blood, meconium, nose, ears, and throat. Another, late-onset meningitis is acquired through vaginal transmission, although it also has been reported with caesarean deliveries.
Central nervous system (CNS) infection (neurolisteriosis): Listeria has a predilection for the brain parenchyma, especially the brain stem, and the meninges. It can cause cranial nerve palsies, encephalitis, meningitis, meningoencephalitis and abscesses. Mental status changes are common. Seizures occur in at least 25% of patients.
Gastroenteritis: L. monocytogenes can produce food-borne diarrheal disease, which typically is noninvasive. The median incubation period is 21 days, with diarrhea lasting anywhere from 1–3 days. Affected people present with fever, muscle aches, gastrointestinal nausea or diarrhea, headache, stiff neck, confusion, loss of balance, or convulsions.Listeria has also been reported to colonize the hearts of some patients. The overall incidence of cardiac infections caused by Listeria is relatively low, with 7–10% of case reports indicating some form of heart involvement. There is some evidence that small subpopulations of clinical isolates are more capable of colonizing the heart throughout the course of infection, but cardiac manifestations are usually sporadic and may rely on a combination of bacterial factors and host predispositions, as they do with other strains of cardiotropic bacteria.
Intractability: Listeriosis is generally not considered intractable. It can usually be treated effectively with antibiotics if diagnosed early. However, it can be severe and potentially life-threatening for certain populations, such as newborns, the elderly, pregnant women, and individuals with weakened immune systems. Early detection and treatment are crucial for managing the infection.
Disease Severity: Listeriosis can range from mild to severe in terms of disease severity. Mild cases may include symptoms like fever and diarrhea, commonly associated with gastrointestinal infection. Severe cases, particularly in vulnerable groups like newborns, elderly, pregnant women, and immunocompromised individuals, can lead to more serious conditions such as septicemia, meningitis, or encephalitis, which can be life-threatening.
Healthcare Professionals: Disease Ontology ID - DOID:11573
Pathophysiology: Listeriosis is primarily caused by the bacterium Listeria monocytogenes. The pathophysiology involves the ingestion of contaminated food, after which the bacteria can cross the intestinal barrier, spread through the bloodstream, and invade various organs. These bacteria have the unique ability to survive and multiply at low temperatures, such as those found in refrigeration.

After entering the body, Listeria can infect macrophages and epithelial cells, allowing it to evade the host's immune system. It often targets the central nervous system, leading to conditions like meningitis or encephalitis, and can cross the placental barrier, posing severe risks to pregnant women and their fetuses, including miscarriage, stillbirth, or neonatal infection.

Listeriosis particularly affects immunocompromised individuals, the elderly, pregnant women, and newborns, leading to symptoms ranging from mild flu-like illness to severe systemic infections.
Carrier Status: In listeriosis, carrier status refers to individuals or animals that harbor the Listeria monocytogenes bacteria without showing symptoms of the disease. These carriers can potentially spread the bacteria to others or contaminate food products. This carrier state poses a significant risk, especially in food production and handling environments, as it can lead to outbreaks of listeriosis. Control measures in food safety practices are essential to minimize this risk. Socially, ensuring high standards of cleanliness and regular health checks in food handlers can help reduce the incidence of carrier status.
Mechanism: Listeriosis is an infection caused by the bacterium Listeria monocytogenes.

**Mechanism:**
Listeria monocytogenes typically enters the human body through the ingestion of contaminated food. Once ingested, the bacteria can cross the intestinal barrier, disseminate via the bloodstream, and invade various tissues, including the liver, spleen, and central nervous system, leading to conditions such as meningitis and septicemia.

**Molecular Mechanisms:**
1. **Internalin-E-cadherin Interaction:** Listeria monocytogenes utilizes surface proteins known as internalins (InlA and InlB) to bind to host cell receptors like E-cadherin and Met. This binding facilitates the internalization of the bacteria into the host cells.

2. **Listeriolysin O (LLO):** Listeriolysin O is a pore-forming toxin essential for the escape of the bacterium from the phagosome into the cytoplasm of the host cell. This evasion from the phagosome is a critical step for intracellular survival and replication.

3. **ActA Protein:** Once inside the cytoplasm, Listeria employs the ActA protein to hijack the host's actin polymerization machinery, promoting actin-based intracellular motility and intercellular spread by forming comet tails, allowing the bacterium to move directly from cell to cell and evade host immune responses.

4. **Phospholipases:** The bacteria produce two types of phospholipases, PlcA and PlcB, which assist in the breakdown of the double-membrane vacuoles formed during cell-to-cell spread.

These molecular mechanisms allow Listeria monocytogenes to efficiently invade host cells, resist intracellular defenses, and disseminate within the host, leading to infection.
Treatment: Bacteremia should be treated for 2 weeks, meningitis for 3 weeks, and brain abscess for at least 6 weeks. Ampicillin generally is considered antibiotic of choice; gentamicin is added frequently for its synergistic effects. Overall mortality rate is 20–30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive.
Compassionate Use Treatment: Compassionate use treatment for listeriosis, where standard treatments may not be effective or viable, might involve access to experimental drugs or therapies not yet fully approved. Off-label treatments can include the use of antibiotics not specifically approved for listeriosis but shown to have efficacy. Experimental treatments might involve novel antibiotics or adjunctive therapies currently in clinical trials. It is crucial to consult healthcare professionals for the most current information and appropriate treatment options.
Lifestyle Recommendations: Lifestyle recommendations for preventing listeriosis include:

1. **Food Safety**:
- Cook raw foods thoroughly, especially meat, poultry, and seafood.
- Avoid unpasteurized dairy products.
- Rinse raw fruits and vegetables under running water before eating.

2. **Hygiene**:
- Wash hands, knives, and cutting boards after handling uncooked foods.
- Sanitize kitchen surfaces regularly.

3. **Food Storage**:
- Keep refrigerated foods at or below 40°F (4°C).
- Follow expiration dates and properly store leftovers within 2 hours of preparing.

4. **High-Risk Groups**:
- Pregnant women, older adults, and individuals with weakened immune systems should avoid deli meats, hot dogs (unless reheated to steaming hot), and certain seafood types.

These practices help reduce the risk of contracting the infection.
Medication: Listeriosis is typically treated with antibiotics. The most commonly used antibiotics for treating listeriosis include ampicillin and gentamicin. The duration of the treatment depends on the severity and the patient's immune status. In severe cases, hospitalization may be required for intravenous (IV) antibiotic therapy.
Repurposable Drugs: Listeriosis is a bacterial infection caused by Listeria monocytogenes. It primarily affects pregnant women, newborns, elderly adults, and individuals with weakened immune systems. While specific repurposable drugs for listeriosis are not well-documented, some antibiotics traditionally used for other infections may be effective.

1. **Ampicillin**: Commonly used to treat listeriosis, often in combination with gentamicin.
2. **Gentamicin**: Used in combination with ampicillin for a synergistic effect.
3. **Trimethoprim-sulfamethoxazole**: May be used as an alternative, especially in patients allergic to penicillin.

Early diagnosis and treatment are crucial to managing listeriosis effectively.
Metabolites: Listeriosis is caused by the bacterium Listeria monocytogenes. Metabolites associated with Listeria infection include:

1. **Lactic Acid:** Produced during anaerobic metabolism.
2. **Acetate:** Resulting from Listeria's metabolic processes.
3. **Carbon Dioxide:** A byproduct of aerobic and anaerobic respiration.
4. **Ethanol:** Can be produced during anaerobic metabolism.

Nanotechnology, while not yet a standard treatment for listeriosis, holds potential for several applications:
1. **Detection:** Nanoparticles can be used in biosensors for rapid and sensitive detection of Listeria.
2. **Drug Delivery:** Nanocarriers might be developed to enhance the delivery of antibiotics directly to infected cells.
3. **Food Safety:** Nanomaterials can be employed in packaging to detect or inhibit bacterial growth, enhancing food safety.
Nutraceuticals: Nutraceuticals and nanotechnology are emerging areas in the management and control of infections like listeriosis. Nutraceuticals, which are foods or food products that provide medical or health benefits, could potentially support the immune system and help in reducing the pathogenicity of Listeria monocytogenes. Probiotics, for example, are one such nutraceutical that may help in maintaining a healthy gut flora, which could inhibit the growth of Listeria.

Nanotechnology offers innovative approaches for the diagnosis, treatment, and prevention of listeriosis. This can include the development of nanosensors for rapid detection of Listeria in food products, as well as nanoparticle-based delivery systems for more effective and targeted antimicrobial therapies. The use of nanomaterials could enhance the efficacy of antimicrobials and reduce side effects by ensuring that the active substances are delivered precisely where needed.
Peptides: Listeriosis is an infection caused by the bacterium Listeria monocytogenes. Peptides related to listeriosis typically refer to small protein fragments used in the immune response against the bacterium. These peptides can help in diagnostics and potential treatments.

Nanotechnology (nan) in listeriosis could involve the development of nanoparticle-based systems for targeted drug delivery, improved diagnostic tests, or even vaccines. Nanoparticles can be engineered to carry antimicrobial agents directly to infected cells or tissues, enhancing the effectiveness of treatments and reducing side effects.