Listeria monocytogenes - Listeriosis

Listeria monocytogenes is the causative agent of listeriosis and is transmitted through contaminated foods. Listeriosis is a virulent foodborne illness with 20-30% mortality, especially in immunocompromised individuals.

Tabs Content

Clinical Overview

Diagnosis

Indications for Testing

High level of suspicion coupled with symptoms in at-risk patients

Laboratory Testing

CDC – diagnosis and testing recommendations
Rapid detection tests may be available (monoclonal antibodies or nucleic acid hybridization) but may only identify genus Listeria
Culture
- Blood
- Cerebrospinal fluid (CSF)
- Amniotic fluid
- Maternal/fetal tissues

Differential Diagnosis

Diarrhea, caused by other agents of gastroenteritis (viral, bacterial, parasitic)
Toxoplasmosis
Encephalitis
Meningitis
Vasculitis

Background

Epidemiology

Prevalence – ~1,600 people/year in U.S. (CDC, 2016)

Organism

Gram-positive facultative, intracellular rods
Hardy organism – capable of growing at both 4ºC and 37ºC
Motile by means of flagella at room temperature, but not at 37ºC (body temperature); can spread from cell to cell via actin polymerization
The only recognized human pathogen in Listeria species; has >14 serotypes
Infection usually follows consumption of contaminated food (listeria can grow and multiply in a refrigerated state)
- Uncooked meats and vegetables
- Unpasteurized milk and cheeses
- Processed foods (eg, soft cheeses, processed meats, smoked seafood)

Risk Factors

Immunocompromised state as a result of
- Corticosteroids
- Transplant drugs
- Cancer
- HIV/AIDS
Chronic diseases
>65 years
Pregnancy

Clinical Presentation

Initial symptoms – fever, muscle aches, nausea, diarrhea
Localized infection
- Skin
- Intra-abdominal
More serious symptoms (may develop if infection spreads)
- Systemic sepsis
- Central nervous system (CNS) infection
  - Meningitis
  - Encephalitis
Manifestations in pregnancy
- Sepsis in mother and newborn
- Spontaneous or septic abortion
- Stillbirth

ARUP Lab Tests

Tests generally appear in the order most useful for common clinical situations. Click on number for test-specific information in the ARUP Laboratory Test Directory.

Blood Culture 0060102
Method: Continuous Monitoring Blood Culture/Identification

Recommended Use

Detect presence of bacteria in blood

Limitations

Testing is limited to the University of Utah Health Sciences Center only

Cerebrospinal Fluid (CSF) Culture and Gram Stain 0060106
Method: Stain/Culture/Identification

Recommended Use

Identify bacteria in CSF

Body Fluid Culture and Gram Stain 0060108
Method: Stain/Culture/Identification

Recommended Use

Identify bacteria in normally sterile body fluids

Anaerobe culture is recommended for body fluids, tissue, and deep wound/surgical cultures; refer to anaerobe culture and gram stain

For CSF specimens, order CSF culture and gram stain

For blood specimens, order blood culture or blood culture, AFB and fungal

Limitations

Anaerobe culture is NOT included with this order

Listeria Antibody, Serum by CF 0099529
Method: Semi-Quantitative Complement Fixation

Recommended Use

Confirm Listeria as agent of infection (endocarditis, central nervous system [CNS])

Document past infection if culture was not performed or if patient received antibiotics that would make culture unreliable

Listeria Antibody, CSF by CF 2002086
Method: Semi-Quantitative Complement Fixation

Recommended Use

Confirm Listeria as agent of infection (CNS)

Document past infection if culture was not performed or if patient received antibiotics that would make culture unreliable

Medical Experts

Fisher, Mark A., PhD, D(ABMM), Medical Director, Bacteriology, and Special Microbiology, Antimicrobial Susceptibility Testing, at ARUP Laboratories; Associate Professor of Clinical Pathology, University of Utah

References

General References

Allerberger F, Wagner M. Listeriosis: a resurgent foodborne infection. Clin Microbiol Infect. 2010; 16(1): 16-23. PubMed

Bortolussi R. Listeriosis: a primer. CMAJ. 2008; 179(8): 795-7. PubMed

Drevets DA, Bronze MS. Listeria monocytogenes: epidemiology, human disease, and mechanisms of brain invasion. FEMS Immunol Med Microbiol. 2008; 53(2): 151-65. PubMed

Gandhi M, Chikindas ML. Listeria: A foodborne pathogen that knows how to survive. Int J Food Microbiol. 2007; 113(1): 1-15. PubMed

Posfay-Barbe KM, Wald ER. Listeriosis. Semin Fetal Neonatal Med. 2009; 14(4): 228-33. PubMed

Ramaswamy V, Cresence VM, Rejitha JS, Lekshmi MU, Dharsana KS, Prasad SP, Vijila HM. Listeria--review of epidemiology and pathogenesis. J Microbiol Immunol Infect. 2007; 40(1): 4-13. PubMed

Last Update: August 2019

Listeria monocytogenes - Listeriosis

Diagnosis

Indications for Testing

Laboratory Testing

Differential Diagnosis

Background

Epidemiology

Organism

Risk Factors

Clinical Presentation

ARUP Lab Tests

Medical Experts

References

General References

ARUP Laboratories

ARUP Websites

ARUP Consult


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	Listeria monocytogenes - Listeriosis. ARUP Consult^©. Retrieved October 8, 2019, from: https://arupconsult.com/content/listeria-monocytogenes

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Listeria monocytogenes - Listeriosis

Diagnosis

Indications for Testing

Laboratory Testing

Differential Diagnosis

Background

Epidemiology

Organism

Risk Factors

Clinical Presentation

ARUP Lab Tests

Medical Experts

References

General References

ARUP Laboratories

ARUP Websites

ARUP Consult