A Case of Listeria monocytogenes ST-219 Meningo-Encephalitis

Abstract

Listeriosis is a foodborne disease characterized by high hospitalization and fatality rates, especially in vulnerable groups including elderly subjects, pregnant women, etc. We report on the first case of Listeria monocytogenes ST-219 meningo-encephalitis in a woman aged 83 years. An epidemiological and molecular investigation was performed to detect the source of infection and the virulence factors associated with L. monocytogenes invasiveness in this patient. All environmental- and clinical-associated isolates were found to belong to serotype 4b and ST-219 as well as possessing actA, prfA, hlyA, and rrn virulence genes. Antibiotic susceptibility testing also detected resistance to cotrimoxazole, clindamycin, erythromycin, and oxacillin in these isolates. Conventional and molecular surveillance of listeriosis cases, based on the systematic assessment of spatio-temporal trends, virulence genes, and antimicrobial susceptibility testing patterns, are key to preventing and controlling the emergence and spread of L. monocytogenes strains, including hypervirulent clones.

Whole-Genome Sequencing-Based Characterization of Listeria Isolates from Produce Packinghouses and Fresh-Cut Facilities Suggests Both Persistence and Reintroduction of Fully Virulent L. monocytogenes

“…More specifically, the most frequent CC (CC388), which represented 15 of the 169 LM isolates in this study, was associated with a pork-related outbreak that sickened more than 200 people in Spain in 2019 ( 32 , 33 ). The 3 next most frequent CCs from this study represented CC4 ( n = 13), CC6 ( n = 12), and CC1 ( n = 11), which have also been associated with human illness ( 15 , 34 – 38 ) and have all been suggested to represent hypervirulent LM ( 15 ). In addition to other outbreaks ( 38 , 39 ), CC4 has been associated with a 2013 outbreak in Switzerland that was linked to salad ( 39 ).…”

“…The 3 next most frequent CCs from this study represented CC4 ( n = 13), CC6 ( n = 12), and CC1 ( n = 11), which have also been associated with human illness ( 15 , 34 – 38 ) and have all been suggested to represent hypervirulent LM ( 15 ). In addition to other outbreaks ( 38 , 39 ), CC4 has been associated with a 2013 outbreak in Switzerland that was linked to salad ( 39 ). We also identified two CC7 isolates, and this CC was associated with the 2011 United States cantaloupe outbreak ( 39 ), indicating that CCs that have previously been associated with produce related outbreaks continue to be found in produce processing facilities.…”

Brain abscess due to listeria monocytogenes

“…Individuals with impaired cell-mediated immunity are at risk of developing listerial infections. The majority of human infections occur in newborns, immunosuppressants, the weak and the elderly [8,9] . Commonly, listeria monocytogenes central nervous system infection presents as meningitis, but very rarely, it can also lead to brain abscesses, and such patients usually have a poor prognosis.…”

Epidemiology and Clinical Features of Listeriosis in Gipuzkoa, Spain, 2010–2020

“…Another notable finding concerns ST219. To our knowledge, only one clinical case has been described in the literature, a case of meningoencephalitis in Italy in 2018 ( Sotgiu et al, 2018 ). The other publications in which ST219 appears report studies of the presence of L. monocytogenes in cattle and food processing plants ( Jorgensen et al, 2021 ; Palacios-Gorba et al, 2021 ).…”