Pregnancy related listeriosis: treatment and control

Abstract

Listeriosis during pregnancy usually presents as an unremarkable febrile illness in the mother but can be fatal for the fetus and newborn. Reliable laboratory testing for early diagnosis is lacking. Serological antibody tests and bacteriological stool tests are not helpful since Listeria-specific antibodies and stool cultures yielding the organism can be found in healthy pregnant women. Because early diagnosis is difficult, diagnosis is usually made by culturing the pathogen from blood, cerebrospinal fluid, placenta or meconium. The mortality rate for fetal and newborn listeriosis remains approximately 20%. Two to three cases of pregnancy-associated listeriosis are reported annually in Austria among approximately 79,000 births, 20–30 cases are reported annually in Germany among approximately 680,000 births and 50–100 cases are reported annually in the USA among approximately 4 million births. Although Listeria infections in pregnancy are rare, they should be considered as a cause of fever of unknown origin during pregnancy.

Keywords:

• diagnosis
• Listeria monocytogenes
• pregnancy
• prevention
• treatment

Acknowledgements

We gratefully acknowledge the valuable contributions to this manuscript made by KA Jackson and B Jackson.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Although Listeria infections in pregnancy are rare, they should be considered as a cause of fever of unknown origin during pregnancy.

• Serological antibody tests are not helpful since Listeria-specific antibodies can be found in healthy pregnant women.

• Diagnosis is usually made by culturing the pathogen from blood, cerebrospinal fluid, placenta or meconium.

• Listeriosis is primarily a foodborne infectious disease.

• For chorioamnionitis caused by maternal Listeria infection, antibiotic therapy is the primary treatment since delaying the delivery can result in carrying the fetus to term and in delivery of a healthy baby.

• No testing, including blood and stool cultures, or treatment is necessary for asymptomatic pregnant women who report consumption of a product that was recalled.

Notes