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Otte Im Kampe E, Salmenlinna S, Åberg R, Wallgren S, Hautaniemi M, Keronen S, Leinonen E, Pihlajasaari A, Ruotsalainen E, Sarvela A, Rimhanen-Finne R. Outbreak of Listeria monocytogenes in hospital linked to a fava bean product, Finland, 2015 to 2019. Euro Surveill 2024; 29:2300488. [PMID: 38726694 PMCID: PMC11083975 DOI: 10.2807/1560-7917.es.2024.29.19.2300488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/26/2024] [Indexed: 05/12/2024] Open
Abstract
Listeria monocytogenes (Lm) is a bacterium widely distributed in the environment. Listeriosis is a severe disease associated with high hospitalisation and mortality rates. In April 2019, listeriosis was diagnosed in two hospital patients in Finland. We conducted a descriptive study to identify the source of the infection and defined a case as a person with a laboratory-confirmed Lm serogroup IIa sequence type (ST) 37. Six cases with Lm ST 37 were notified to the Finnish Infectious Diseases Registry between 2015 and 2019. Patient interviews and hospital menus were used to target traceback investigation of the implicated foods. In 2021 and 2022, similar Lm ST 37 was detected from samples of a ready-to-eat plant-based food product including fava beans. Inspections by the manufacturer and the local food control authority indicated that the food products were contaminated with Lm after pasteurisation. Our investigation highlights the importance that companies producing plant-based food are subject to similar controls as those producing food of animal origin. Hospital menus can be a useful source of information that is not dependent on patient recall.
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Affiliation(s)
- Eveline Otte Im Kampe
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - Riikka Åberg
- Food Safety Unit, Environmental Services, City of Helsinki, Finland
| | | | | | - Satu Keronen
- Abdominal Center, Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | - Eeva Ruotsalainen
- Division of Infectious Diseases, Inflammation Center, HUS Helsinki University Hospital, Helsinki, Finland
| | - Anna Sarvela
- Environmental office, City of Seinäjoki, Seinäjoki, Finland
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Russini V, Spaziante M, Varcasia BM, Diaconu EL, Paolillo P, Picone S, Brunetti G, Mattia D, De Carolis A, Vairo F, Bossù T, Bilei S, De Marchis ML. A Whole Genome Sequencing-Based Epidemiological Investigation of a Pregnancy-Related Invasive Listeriosis Case in Central Italy. Pathogens 2022; 11:667. [PMID: 35745521 PMCID: PMC9228178 DOI: 10.3390/pathogens11060667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
Listeriosis is currently the fifth most common foodborne disease in Europe. Most cases are sporadic; however, outbreaks have also been reported. Compared to other foodborne infections, listeriosis has a modest incidence but can cause life-threatening complications, especially in elderly or immunocompromised people and pregnant women. In the latter case, the pathology can be the cause of premature birth or spontaneous abortion, especially if the fetus is affected during the first months of gestation. The causative agent of listeriosis, Listeria monocytogenes, is characterized by the innate ability to survive in the environment and in food, even in adverse conditions and for long periods. Ready-to-eat food represents the category most at risk for contracting listeriosis. This study presents the result of an investigation carried out on a case of maternal-fetal transmission of listeriosis which occurred in 2020 in central Italy and which was linked, with a retrospective approach, to other cases residing in the same city of the pregnant woman. Thanks to the use of next-generation sequencing methodologies, it was possible to identify an outbreak of infection, linked to the consumption of ready-to-eat sliced products sold in a supermarket in the investigated city.
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Affiliation(s)
- Valeria Russini
- Food Microbiology Unit, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, 00178 Rome, Italy; (V.R.); (B.M.V.); (T.B.); (S.B.)
| | - Martina Spaziante
- Regional Service Surveillance and Control for Infectious Diseases (SERESMI), National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, Italy; (M.S.); (F.V.)
| | - Bianca Maria Varcasia
- Food Microbiology Unit, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, 00178 Rome, Italy; (V.R.); (B.M.V.); (T.B.); (S.B.)
| | - Elena Lavinia Diaconu
- Department of General Diagnostics, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, 00178 Rome, Italy;
| | - Piermichele Paolillo
- UO Neonatologia, Patologia Neonatale e Terapia Intensiva Neonatale (TIN), Policlinico Casilino General Hospital, 00169 Rome, Italy; (P.P.); (S.P.)
| | - Simonetta Picone
- UO Neonatologia, Patologia Neonatale e Terapia Intensiva Neonatale (TIN), Policlinico Casilino General Hospital, 00169 Rome, Italy; (P.P.); (S.P.)
| | - Grazia Brunetti
- Pathology-Microbiology Laboratory, Policlinico Casilino General Hospital, 00169 Rome, Italy;
| | - Daniela Mattia
- Dipartimento di Prevenzione, Servizio Veterinario Area B—Igiene Alimenti di Origine Animale (SIOA), ASL Roma 6, 00072 Rome, Italy;
| | - Angela De Carolis
- Dipartimento di Prevenzione, Servizio di Igiene degli Alimenti e della Nutrizione (SIAN), ASL Roma 6, 00044 Rome, Italy;
| | - Francesco Vairo
- Regional Service Surveillance and Control for Infectious Diseases (SERESMI), National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, Italy; (M.S.); (F.V.)
| | - Teresa Bossù
- Food Microbiology Unit, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, 00178 Rome, Italy; (V.R.); (B.M.V.); (T.B.); (S.B.)
| | - Stefano Bilei
- Food Microbiology Unit, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, 00178 Rome, Italy; (V.R.); (B.M.V.); (T.B.); (S.B.)
| | - Maria Laura De Marchis
- Food Microbiology Unit, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, 00178 Rome, Italy; (V.R.); (B.M.V.); (T.B.); (S.B.)
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Russini V, Spaziante M, Zottola T, Fermani AG, Di Giampietro G, Blanco G, Fabietti P, Marrone R, Parisella R, Parrocchia S, Bossù T, Bilei S, De Marchis ML. A Nosocomial Outbreak of Invasive Listeriosis in An Italian Hospital: Epidemiological and Genomic Features. Pathogens 2021; 10:pathogens10050591. [PMID: 34066208 PMCID: PMC8150339 DOI: 10.3390/pathogens10050591] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/29/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Listeria monocytogenes (L. monocytogenes) is a widespread opportunistic pathogen that causes the listeriosis foodborne disease. This bacterium has become a common contaminant of handled food, and a relevant public health issue. Here we describe a nosocomial outbreak of listeriosis caused by an ST451 strain of L. monocytogenes involving three cancer and one immunocompromised patients hospitalized in different units from the same hospital during September and October 2020. The epidemiological investigation was conducted using traditional microbiological methodology combined with a whole genome sequencing approach. The source of contamination was identified in the kitchen hospital, where a meat slicer used to prepare patients’ meals was tested positive to the same sequence type (ST) of L. monocytogenes. This is the first report of an outbreak of listeriosis caused by ST451 in Italy.
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Affiliation(s)
- Valeria Russini
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Martina Spaziante
- Regional Service Surveillance and Control for Infectious Diseases (SERESMI), National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, 00149 Rome, Italy;
| | - Tiziana Zottola
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Latina, 04100 Latina, Italy;
| | | | - Gina Di Giampietro
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Giovanni Blanco
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Paolo Fabietti
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Riccardo Marrone
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Roberta Parisella
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Sergio Parrocchia
- Ospedale Santa Maria Goretti, 04100 Latina, Italy; (G.B.); (P.F.); (R.M.); (R.P.); (S.P.)
| | - Teresa Bossù
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Stefano Bilei
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
| | - Maria Laura De Marchis
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”—Sezione di Roma, 00178 Rome, Italy; (V.R.); (G.D.G.); (T.B.); (S.B.)
- Correspondence:
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It Is Not All about Single Nucleotide Polymorphisms: Comparison of Mobile Genetic Elements and Deletions in Listeria monocytogenes Genomes Links Cases of Hospital-Acquired Listeriosis to the Environmental Source. J Clin Microbiol 2015; 53:3492-500. [PMID: 26311854 DOI: 10.1128/jcm.00202-15] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 08/14/2015] [Indexed: 12/22/2022] Open
Abstract
The control of food-borne outbreaks caused by Listeria monocytogenes in humans relies on the timely identification of food or environmental sources and the differentiation of outbreak-related isolates from unrelated ones. This study illustrates the utility of whole-genome sequencing for examining the link between clinical and environmental isolates of L. monocytogenes associated with an outbreak of hospital-acquired listeriosis in Sydney, Australia. Comparative genomic analysis confirmed an epidemiological link between the three clinical and two environmental isolates. Single nucleotide polymorphism (SNP) analysis showed that only two SNPs separated the three human outbreak isolates, which differed by 19 to 20 SNPs from the environmental isolates and 71 to >10,000 SNPs from sporadic L. monocytogenes isolates. The chromosomes of all human outbreak isolates and the two suspected environmental isolates were syntenic. In contrast to the genomes of background sporadic isolates, all epidemiologically linked isolates contained two novel prophages and a previously unreported clustered regularly interspaced short palindromic repeat (CRISPR)-associated (Cas) locus subtype sequence. The mobile genetic element (MGE) profile of these isolates was distinct from that of the other serotype 1/2b reference strains and sporadic isolates. The identification of SNPs and clonally distinctive MGEs strengthened evidence to distinguish outbreak-related isolates of L. monocytogenes from cocirculating endemic strains.
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Silk BJ, McCoy MH, Iwamoto M, Griffin PM. Foodborne listeriosis acquired in hospitals. Clin Infect Dis 2014; 59:532-40. [PMID: 24846635 DOI: 10.1093/cid/ciu365] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods.
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Affiliation(s)
- Benjamin J Silk
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Morgan H McCoy
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis
| | - Martha Iwamoto
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patricia M Griffin
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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Gaul LK, Farag NH, Shim T, Kingsley MA, Silk BJ, Hyytia-Trees E. Hospital-acquired listeriosis outbreak caused by contaminated diced celery--Texas, 2010. Clin Infect Dis 2012; 56:20-6. [PMID: 22997210 DOI: 10.1093/cid/cis817] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Listeria monocytogenes causes often-fatal infections affecting mainly immunocompromised persons. Sources of hospital-acquired listeriosis outbreaks can be difficult to identify. We investigated a listeriosis outbreak spanning 7 months and involving 5 hospitals. METHODS Outbreak-related cases were identified by pulsed-field gel electrophoresis (PFGE) and confirmed by multiple-locus variable-number tandem-repeat analysis (MLVA). We conducted patient interviews, medical records reviews, and hospital food source evaluations. Food and environmental specimens were collected at a hospital (hospital A) where 6 patients had been admitted before listeriosis onset; these specimens were tested by culture, polymerase chain reaction (PCR), and PFGE. We collected and tested food and environmental samples at the implicated processing facility. RESULTS Ten outbreak-related patients were immunocompromised by ≥1 underlying conditions or treatments; 5 died. All patients had been admitted to or visited an acute-care hospital during their possible incubation periods. The outbreak strain of L. monocytogenes was isolated from chicken salad and its diced celery ingredient at hospital A, and in 19 of >200 swabs of multiple surfaces and in 8 of 11 diced celery products at the processing plant. PCR testing detected Listeria in only 3 of 10 environmental and food samples from which it was isolated by culturing. The facility was closed, products were recalled, and the outbreak ended. CONCLUSIONS Contaminated diced celery caused a baffling, lengthy outbreak of hospital-acquired listeriosis. PCR testing often failed to detect the pathogen, suggesting its reliability should be further evaluated. Listeriosis risk should be considered in fresh produce selections for immunocompromised patients.
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Affiliation(s)
- Linda Knudson Gaul
- Emerging and Acute Infectious Diseases Branch, Texas Department of State Health Services, 1100 W 49th St, Austin, TX 78756, USA.
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A large outbreak of Listeria monocytogenes infection with short incubation period in a tertiary care hospital. J Infect 2010; 61:465-70. [PMID: 20813130 DOI: 10.1016/j.jinf.2010.08.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 08/19/2010] [Accepted: 08/23/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Listeria monocytogenes is a foodborne pathogen with a high mortality rate. We report a large, nosocomial outbreak of Listeria monocytogenes infection. METHODS Patients with L. monocytogenes isolated from a sterile site, or from faeces when diarrhoea and fever were present, were included. Clinical data were collected from the patient records. The incubation period was calculated as the time between exposure and start of symptoms. RESULTS Seventeen patients (11 women, median age 64 years) were infected of whom 15 patients were at increased risk for listeriosis. Eleven patients received empiric antibiotic treatment, eight of them with cephalosporins. Three patients died with a resulting mortality rate of 18%. The source of the outbreak was a Camembert cheese made from pasteurised milk containing up to 360 million colony forming units per portion. The median incubation period was 3-4 days. CONCLUSIONS The incubation period in this outbreak was significantly shorter than previously reported, a fact that may be due to the high number of ingested bacteria. Furthermore, food restrictions in hospitals seem warranted, as do treatment with antibiotics effective against L. monocytogenes in at-risk populations.
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Orthotopic Liver Transplantation: Is There a Risk for Listeria monocytogenes Infection? Case Rep Med 2010; 2010:901894. [PMID: 20300589 PMCID: PMC2837907 DOI: 10.1155/2010/901894] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 02/14/2010] [Accepted: 02/22/2010] [Indexed: 12/16/2022] Open
Abstract
Immunosuppression of any kind is a known risk factor for infection with Listeria monocytogenes (L. monocytogenes). Particularly, patients with impaired liver function are at increased risk of developing an aggravated course of infection with this bacterial pathogen (see Nolla-Salas et al.; 2002 and Cabellos et al.; 2008). It is a well-known pathogen in immunocompromised patients, but has only seldom been reported following orthotopic liver transplantation. Invasion of the central nervous system presenting as meningitis or meningoencephalitis and bacteremia are the principal clinical manifestations of listerial infections (see Brouwer et al.; 2006). We present an account of a case of a patient who developed L. monocytogenes meningitis during the early period after liver transplantation.
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Le Monnier A, Leclercq A. Listeria et listériose : des animaux d’élevage à nos assiettes. ACTA ACUST UNITED AC 2009; 57:17-22. [DOI: 10.1016/j.patbio.2008.07.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Accepted: 07/04/2008] [Indexed: 11/26/2022]
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Kruszyna T, Walsh M, Peltekian K, Molinari M. Early invasive Listeria monocytogenes infection after orthotopic liver transplantation: case report and review of the literature. Liver Transpl 2008; 14:88-91. [PMID: 18161771 DOI: 10.1002/lt.21428] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Infection with Listeria monocytogenes is rare, with a reported annual incidence of 4.4 cases per million individuals. It is caused by a gram-positive rod-shaped bacterium (Listeria monocytogenes) that can be found in soil, vegetation, water, sewage, and silage and in feces of humans and animals. It is a facultative intracellular pathogen with the ability to survive and multiply in phagocytic host cells, even in adverse environmental circumstances. Listeriosis has rarely been reported after orthotopic liver transplantation, and transplant physicians are often unfamiliar with the clinical presentation of this rare but virulent infection, which accounts for 20%-30% mortality in affected individuals. We present a case of invasive Listeria infection causing bacteremia and peritonitis in the early postoperative period after cadaveric liver transplantation in a previously asymptomatic patient.
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Affiliation(s)
- Thomas Kruszyna
- Dalhousie University Hospital, MOTP Program, Halifax, Nova Scotia, Canada
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Mizuno S, Zendejas IR, Reed AI, Kim RD, Howard RJ, Hemming AW, Schain DC, Soldevila-Pico C, Firpi RJ, Fujita S. Listeria monocytogenes following orthotopic liver transplantation: Central nervous system involvement and review of the literature. World J Gastroenterol 2007; 13:4391-3. [PMID: 17708617 PMCID: PMC4250870 DOI: 10.3748/wjg.v13.i32.4391] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Listeria monocytogene is a well-recognized cause of bacteremia in immunocompromised individuals, including solid organ transplant recipients, but has been rarely reported following orthotopic liver transplantation. We describe a case of listeria meningitis that occurred within a week after liver transplantation. The patient developed a severe headache that mimicked tacrolimus encephalopathy, and was subsequently diagnosed with listeria meningitis by cerebrospinal fluid culture. The infection was successfully treated with three-week course of intravenous ampicillin. Recurrent hepatitis C followed and was successfully treated with interferon alfa and ribavirin. Fourteen cases of listeriosis after orthotopic liver transplantation have been reported in the English literature. Most reported cases were successfully treated with intravenous ampicillin. There were four cases of listeria meningitis, and the mortality of them was 50%. Early detection and treatment of listeria meningitis are the key to obtaining a better prognosis.
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Affiliation(s)
- Shugo Mizuno
- Division of Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Florida College of Medicine, PO Box 100286, Gainesville, FL 32610-0286, United States
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Gottlieb SL, Newbern EC, Griffin PM, Graves LM, Hoekstra RM, Baker NL, Hunter SB, Holt KG, Ramsey F, Head M, Levine P, Johnson G, Schoonmaker-Bopp D, Reddy V, Kornstein L, Gerwel M, Nsubuga J, Edwards L, Stonecipher S, Hurd S, Austin D, Jefferson MA, Young SD, Hise K, Chernak ED, Sobel J. Multistate outbreak of Listeriosis linked to turkey deli meat and subsequent changes in US regulatory policy. Clin Infect Dis 2005; 42:29-36. [PMID: 16323088 DOI: 10.1086/498113] [Citation(s) in RCA: 129] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Accepted: 08/07/2005] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Listeriosis, a life-threatening foodborne illness caused by Listeria monocytogenes, affects approximately 2500 Americans annually. Between July and October 2002, an uncommon strain of L. monocytogenes caused an outbreak of listeriosis in 9 states. METHODS We conducted case finding, a case-control study, and traceback and microbiological investigations to determine the extent and source of the outbreak and to propose control measures. Case patients were infected with the outbreak strain of L. monocytogenes between July and November 2002 in 9 states, and control patients were infected with different L. monocytogenes strains. Outcome measures included food exposure associated with outbreak strain infection and source of the implicated food. RESULTS Fifty-four case patients were identified; 8 died, and 3 pregnant women had fetal deaths. The case-control study included 38 case patients and 53 control patients. Case patients consumed turkey deli meat much more frequently than did control patients (P = .008, by Wilcoxon rank-sum test). In the 4 weeks before illness, 55% of case patients had eaten deli turkey breast more than 1-2 times, compared with 28% of control patients (odds ratio, 4.5; 95% confidence interval, 1.3-17.1). Investigation of turkey deli meat eaten by case patients led to several turkey processing plants. The outbreak strain was found in the environment of 1 processing plant and in turkey products from a second. Together, the processing plants recalled > 30 million pounds of products. Following the outbreak, the US Department of Agriculture's Food Safety and Inspection Service issued new regulations outlining a L. monocytogenes control and testing program for ready-to-eat meat and poultry processing plants. CONCLUSIONS Turkey deli meat was the source of a large multistate outbreak of listeriosis. Investigation of this outbreak helped guide policy changes designed to prevent future L. monocytogenes contamination of ready-to-eat meat and poultry products.
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Affiliation(s)
- Sami L Gottlieb
- Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Rohde H, Horstkotte MA, Loeper S, Aberle J, Jenicke L, Lampidis R, Mack D. Recurrent Listeria monocytogenes aortic graft infection: confirmation of relapse by molecular subtyping. Diagn Microbiol Infect Dis 2004; 48:63-7. [PMID: 14761724 DOI: 10.1016/j.diagmicrobio.2003.08.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2002] [Revised: 08/06/2003] [Indexed: 10/26/2022]
Abstract
Based on molecular typing methods, we identified a rare case of a recurrent L. monocytogenes infection resulting from an infected aortic prosthesis as detected by 18-F-Fluoro-d-deoxyglucose positron emission tomography (FDG PET). Our case highlights the usefulness of molecular typing and nuclear imaging methods for understanding L. monocytogenes pathogenesis and epidemiology.
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Affiliation(s)
- Holger Rohde
- Institut für Infektionsmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistrabetae 52, D-20246 Hamburg, Germany.
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Colodner R, Sakran W, Miron D, Teitler N, Khavalevsky E, Kopelowitz J. Listeria monocytogenes cross-contamination in a nursery [corrected]. Am J Infect Control 2003; 31:322-4. [PMID: 12888770 DOI: 10.1067/mic.2003.25] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Molecular evidence of Listeria monocytogenes cross-contamination in a nursery is presented. Listeria monocytogenes serotype 4b was isolated from the blood and the conjunctiva of a baby with neonatal sepsis who was born after septic amnionitis and premature rupture of membrane. Nine days later, the same bacterium was isolated from the cerebrospinal fluid of a second baby presenting with meningitis. Cervical cultures from the second baby's healthy mother were negative for Listeria sp. An in-depth epidemiologic investigation revealed that the same nurse administered routine treatments to both babies in the nursery during a 1-hour interval of time [corrected]. Pulse-field gel electrophoresis analysis of both strains with 2 different restriction enzymes demonstrated that they were identical and differ from other wild strains of L monocytogenes serotype 4b isolated in Israel. This fact strongly suggests that the second baby was infected during admittance to the nursery as a result of a hospital cross-contamination.
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Rettally CA, Speeg KV. Infection with Listeria monocytogenes following orthotopic liver transplantation: case report and review of the literature. Transplant Proc 2003; 35:1485-7. [PMID: 12826201 DOI: 10.1016/s0041-1345(03)00510-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Infection with Listeria monocytogenes is rare with a reported annual incidence of 4.4 cases/million individuals. Epidemiological data have identified certain groups to be higher risk of developing listeriosis, including neonates, pregnant women, adults older than 60 years of age, individuals afflicted with hematologic malignancies, acquired immunodeficicency syndrome, cirrhosis, and those receiving corticosteroid therapy and organ transplants. Within this last group, multiple cases have been described following bone marrow and renal transplantation, but only a few following liver transplantation. We report a case of a 66-year-old woman presenting with Listeria monocytogenes bacteremia at 32 months following orthotopic liver transplantation.
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Affiliation(s)
- C A Rettally
- Department of Organ Transplantation, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.
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16
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Sepsis and pleural effusion due to a multiresistant Listeria monocytogenes strain after an orthotopic liver transplantation. Med Mal Infect 2003. [DOI: 10.1016/s0399-077x(03)00105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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17
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Slifka MK, Homann D, Tishon A, Pagarigan R, Oldstone MBA. Measles virus infection results in suppression of both innate and adaptive immune responses to secondary bacterial infection. J Clin Invest 2003; 111:805-10. [PMID: 12639986 PMCID: PMC153759 DOI: 10.1172/jci13603] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2001] [Accepted: 01/28/2003] [Indexed: 12/31/2022] Open
Abstract
Among infectious agents, measles virus (MV) remains a scourge responsible for 1 million deaths per year and is a leading cause of childhood deaths in developing countries. Although MV infection itself is not commonly lethal, MV-induced suppression of the immune system results in a greatly increased susceptibility to opportunistic bacterial infections that are largely responsible for the morbidity and mortality associated with this disease. Despite its clinical importance, the underlying mechanisms of MV-induced immunosuppression remain unresolved. To begin to understand the basis of increased susceptibility to bacterial infections during MV infection, we inoculated transgenic mice expressing the MV receptor, CD46, with MV and Listeria monocytogenes. We found that MV-infected mice were more susceptible to infection with Listeria and that this corresponded with significantly decreased numbers of macrophages and neutrophils in the spleen and substantial defects in IFN-gamma production by CD4(+) T cells. The reduction in CD11b(+) macrophages and IFN-gamma-producing T cells was due to reduced proliferative expansion and not to enhanced apoptosis or to altered distribution of these cells between spleen, blood, and the lymphatic system. These results document that MV infection can suppress both innate and adaptive immune responses and lead to increased susceptibility to bacterial infection.
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Affiliation(s)
- Mark K Slifka
- Oregon Health and Science University Vaccine and Gene Therapy Institute, Beaverton, Oregon, USA
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18
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Abstract
There is an ongoing controversy in Europe about the benefits and limitations of epidemiologic methods for the prevention and control of hospital-acquired infections. Hospital epidemiology, aimed at measuring the necessity, or effect, of preventive strategies for nosocomial infection control, is still an unknown field in many European institutions. The conceptual framework presented here is not intended as a complete review of modern hospital epidemiology, but should be considered rather a viewpoint which tries to bridge the gap between microbiology-based hospital hygiene and hospital epidemiology in Europe. The explanatory power and limitations of descriptive, analytical and interventional epidemiology are described. Based on the assumption that nosocomial infections have causal and preventive factors that can be identified through systematic investigation, epidemiologic methods add important knowledge to reduce hospital-acquired infections.
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Affiliation(s)
- S Harbarth
- Division of Infectious Diseases and Infection Control, Children's Hospital, Harvard Medical School, Boston, USA.
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Gorodetskaya I, Matel J, Chertow GM. Issues in renal nutrition for persons from the former Soviet Union. J Ren Nutr 2000; 10:98-102. [PMID: 10757823 DOI: 10.1016/s1051-2276(00)90007-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Dietary practices differ greatly among individuals by race and ethnicity. The importance of these differences is accentuated in patients with end-stage renal disease, a population for whom dietary restrictions are often prescribed. In addition to the known variation in dietary practices among US-born whites and African-Americans, persons of other ethnicities often present new and unique challenges to the dialysis-nutrition care team. The UCSF-Mt. Zion Dialysis Unit (San Francisco, CA) is a university-affiliated dialysis unit that serves an ethnically diverse population in San Francisco's Western Addition neighborhood. Ten percent to 15% of patients are recent immigrants from the former Soviet Union. This report highlights the dietary practices of this immigrant community and the need for ethnicity-specific renal nutrition recommendations in modern dialysis practice.
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Affiliation(s)
- I Gorodetskaya
- Dialysis Unit, UCSF-Mt. Zion Medical Center, San Francisco, CA, USA
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Limaye AP, Perkins JD, Kowdley KV. Listeria infection after liver transplantation: report of a case and review of the literature. Am J Gastroenterol 1998; 93:1942-4. [PMID: 9772060 DOI: 10.1111/j.1572-0241.1998.00550.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Listeria monocytogenes is a well-recognized cause of bacteremia and meningitis in immunocompromised individuals, including recipients of solid organ transplants, but has only rarely been reported following orthotopic liver transplantation (OLT). Most previously reported cases of listeriosis occurred months to years following liver transplantation; we describe a case of listeriosis that occurred within 1 wk of liver transplantation, shortly after discontinuation of trimethoprim-sulfamethoxazole prophylaxis, and review the English literature on Listeria infection after OLT. The patient developed abdominal pain and fever that suggested a bile leak, but was definitively diagnosed with Listeria infection by blood culture. The infection was successfully treated with 3 wk of intravenous ampicillin. We conclude that serious systemic infection with Listeria monocytogenes is uncommon following OLT, may occur early in the postoperative period, and responds well to treatment with high dose ampicillin.
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Affiliation(s)
- A P Limaye
- Department of Laboratory Medicine, University of Washington, Seattle, USA
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