G448(P) Nosocomial neonatal listeria monocytogenes transmission: a report of two cases and a review of the literature

Abstract

Methods Clinical and laboratory data of 48 newborn babies in the early neonatal period were studied. 22 babies (main group) had the generalised herpetic infection. The control group was comprised of 26 clinically healthy babies. The intrauterine herpetic infection was diagnosed on the basis of the disease pattern, detected DNA of HSV-1 and HSV-2 in blood and urine, increasing titers of the specific IgG to HSV over time and detected IgM in the blood serum. TLR-2 (CD14 + CD282 + ) expression in monocytes was detected by means of cytofluorometry (Beckman Coulter). The polymorphism of allelic variants of TLR-2 genes was studied by means of PCR. The content of IFN-a in the blood serum was determined by immune-enzyme analysis (BCM-Diagnostic, USA). Results The decreased expression of TLR-2 (CD14 + CD282 + ) in monocytes of the peripheral blood (43.8 ± 8.3% as against 76.2 ± 5.6%, p<0.05) was revealed in the main group as compared with the control group. The performed frequency studies of the polymorphism of TLR-2 genes revealed that in the newborn babies with the generalised herpetic infection the frequency of Arg753Gln genotype of TLR-2 gene was significantly higher in comparison with the control group (26.3% and 3.8% correspondingly, p<0.05). The correlation between Arg/Gln allele of TLR-2 gene and the indices of nonspecific organism protection was revealed. It appeared that the patients, who were carriers of Gln allele in heterozygous condition, the level of IFN-a was significantly different from the indices of the group without the given polymorphism from the statistic point of view (0.49 ± 0.01 pg/ml as against 0.1 ± 0.01 pg/ml, p<0.05). Conclusion The babies with the generalised intrauterine herpetic infection have the decreased expression of TLR-2 in monocytes as well as the allelic polymorphism of TLR-2 gene in the points of Arg753Gln and the decreased level of IFN-a. The revealed peculiarities of the innate immunity factors explain high sensitivity of the newborn babies in relation to the herpetic infection and confirm their role in the development of the disease pattern.