Neonatal cross-infection due to Listeria monocytogenes

Abstract

Neonatal listeriosis is rare and detecting more than one case together would be unlikely without a causal link. Thirty-five instances of neonatal listeriosis where cross-infection occurred in the UK and Ireland were reviewed together with 29 other similar episodes reported elsewhere. All instances comprised an infant who was ill at or within one day of delivery and who had direct or indirect contact with a second infant, or in the minority, two or more infants, who then usually developed meningitis 6 to 12 days later. In most instances, the infants were nursed on the same day in obstetric units or new-born nurseries and consequently, staff and equipment were common: hence, the likely route of transmission was via direct or indirect neonate to neonate contact. In one instance, a stethoscope was used on both infants nursed in different parts of the same hospital. In a further incident, the mother of the early-onset infant cuddled a baby from an adjacent bed who developed meningitis 12 days later. The largest outbreak occurred in Costa Rica where nine neonatal listeriosis cases resulted after bathing in mineral-oil shortly after birth which had been contaminated from the early-onset index case.

Clinical Features and Antibiotic Treatment of Neonatal Listeriosis: A Hospital-Based Study

“… 9 Late-onset listeriosis is less common than early-onset disease. 3 In our study, all cases were early-onset infection within the first 72 hours of life. Prematurity, fever, a diffuse maculopapular cutaneous eruption, and significant hepatic involvement with jaundice are all the characteristic clinical features of LM infected neonates.…”

“… 1 , 2 LM is responsible for listeriosis, an uncommon disease, but considered as the most severe foodborne infection in the European Union in terms of death and hospitalization. 3 Listeriosis is predominantly affects immunocompromised individuals, such as the elderly, pregnant women and neonates. 4 …”

Listeria monocytogenes—How This Pathogen Uses Its Virulence Mechanisms to Infect the Hosts

“…L. monocytogenes is also able to cross the placental barrier and infect the fetus in pregnant women, resulting in still-birth or frequent lethal neonatal infections [20,199,200] (Figure 2). The whole entry process is not fully clarified, but it seems that bacteria may cross the endothelium of the maternal blood vessels and then pass into the fetal circulatory system of the placental villi [21,96].…”

Fatal neonatal listeriosis following L. monocytogenes horizontal transmission highlights neonatal susceptibility to orally acquired listeriosis

“… 8 Such cases have also been reported in neonatal units, suggesting possible horizontal transmission through contaminated surfaces or equipment. 9 , 10 , 11 , 12 , 13 Several observations have suggested a possible transmission from one infected neonate to another, either directly or via contaminated hospital furniture and personnel. However, this has mostly been based on poorly discriminatory typing methods such as serotyping, lysotyping, or pulsed-field gel electrophoresis (PFGE), as recently reviewed.…”

“…However, this has mostly been based on poorly discriminatory typing methods such as serotyping, lysotyping, or pulsed-field gel electrophoresis (PFGE), as recently reviewed. 13 …”