Listeria monocytogenes it is a pathogenic bacterium, commonly associated with food contamination. It has a wide distribution worldwide in environments such as soils, fresh and sewage waters, vegetation and fecal matter. It can infect humans, cattle, goats, sheep, birds (turkeys, chickens, pheasants, webbed), fish and crustaceans.
The transmission of this bacterium in humans occurs mainly through the ingestion of contaminated foods of animal and vegetable origin, fresh and processed, unpasteurized milk and dairy products, pork, beef, poultry and fish. Mainly those foods that are consumed fresh or with long periods of refrigeration.
It can also be transmitted by direct contact with infected animals, their tissues, their feces or their contaminated environment (zoonosis), by horizontal contamination (mother-child) or by intra-hospital or nosocomial contamination in obstetric and gynecological activities..
Listeriosis is a rare disease (they occur in 0.1 to 10 cases per year per million people) that can become serious in pregnant women, the elderly, infants and immunosuppressed people, such as patients with HIV / AIDS, leukemia, cancer, transplants kidney or corticosteroid therapy.
By presenting a mortality rate of 20 to 30%, it is considered by the World Health Organization as an important public health problem.
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-The bacteria L. monocytogenes They are gram-positive, motile, non-sporulated, facultative anaerobic and pathogenic coccobacilli.
-Has a facultative anaerobic metabolism.
-They are catalase positive and oxidase negative.
-They are able to survive in a wide range of temperatures (from -18 to 50 ºC) and pH (from 3.3 to 9.6) and tolerate salt concentrations of 20%.
-They are distributed worldwide, in a great diversity of environments. This wide distribution is due to its ability to survive for prolonged periods of time in different media, under very broad conditions of temperature, pH and salinity..
-These same characteristics give it great potential to contaminate food in any link in the production chain, including during cold storage..
L. monocytogenes it is a bacterium belonging to the phylum Firmicutes and to the order of the Bacillales. It was described in 1926 as Bacterium monocytogenes, renamed as Listerella hepatolitica in 1927 and finally called Listeria monocytogenes In 1940.
It was the only species recognized for the genus until 1961. Currently 17 species of Listerella, 9 of which have been described after 2009.
Its specific epithet is due to the ability of its membrane extracts to stimulate the production of monocytes in laboratory-infected rabbits and guinea pigs..
L. monocytogenes is rod-shaped and can be 0.4 to 0.5 microns wide by 0.5 to 1.2 microns long.
It has peritrichous flagella, which give it a particular mobility, which are inactivated above 37ºC..
The pathogenicity of L. monocytogenes is a result of their ability to adhere, invade, and multiply within different non-phagocytic cells.
Colonization of host tissues begins, in most cases, after ingestion of contaminated food. In the stomach, L. monocytogenes it must support proteolytic enzymes, gastric acid and bile salts, for which it induces at least 13 oxidative stress proteins and 14 toxic “shock” proteins.
Later the cells of L. monocytogenes they overcome the intestinal barrier through blood and lymph, reaching the lymph nodes, spleen and liver. Bacteria multiply mainly in hepatocytes. The passage from hepatocyte to hepatocyte produces an infectious focus in which the bacteria spread through the liver parenchyma.
L. monocytogenes it is capable of infecting a wide variety of tissues in the host. However, there is evidence that this organism prefers the gravid uterus and the central nervous system..
In humans, infection of the placenta occurs by colonization of the trophoblastic membrane and subsequent translocation of the endothelial barrier. Through this route, the bacteria reach the fetal bloodstream, producing a generalized infection that leads to the death of the fetus in utero or the premature death of the infected neonate..
Finally, infection of the central nervous system occurs by centripetal migration along the cranial nerves, producing meningitis, associated with the presence of infectious foci in the brain parenchyma, especially in the brain stem, with macroscopic lesions restricted to the soft brain and to the cerebellum.
Infection by L. monocytogenes it is called listeriosis. It usually occurs in the form of asymptomatic infection and has a relatively low occurrence.
Noninvasive listeriosis causes acute febrile gastroenteritis. It is the mild form that mostly affects healthy people. It is associated with the intake of food contaminated with high populations of L. monocytogenes. It has a short incubation period. Non-invasive listeriosis cases generate the following symptoms:
Invasive listeriosis is associated with high-risk groups, such as pregnant women, the elderly, infants, and immunosuppressed people, such as patients with HIV / AIDS, leukemia, cancer, kidney transplants, or corticosteroid therapy..
It is characterized by a high mortality rate (20-30%). The incubation period lasts between 1 and 2 weeks, but can be extended up to 3 months.
It can cause skin eruptions in the form of papules or pustules on the arms or hands, frequently associated with contact with infected animals; conjunctivitis and inflammation of the lymph nodes in front of the ears and in more complicated cases can cause meningitis, meningoencephalitis and sometimes rhomboencephalitis.
Other forms of the disease can cause arthritis, endocarditis, endophthalmitis, peritonitis, pleural effusions, internal and external abscesses, among others..
Likewise, it can cause spontaneous abortion or fetal death, in cases of infections in the uterus and fetus of pregnant women. In newborns it can also cause low birth weight, septicemia, meningitis or meningoencephalitis.
Invasive listeriosis cases can generate several of the symptoms mentioned below:
The most commonly used treatment to treat infections of the L. monocytogenes is a combination of gentamicin with broad spectrum penicillins such as ampicillin.
The combination of trimethoprim and sulfamethoxazole has also been used in patients allergic to penicillin. In patients with meningoencephalitis, aminoglycosides are also often used, together with the base treatment of penicillin or ampicillin..
However, the effectiveness of the treatment depends on the strains, since it is a bacterium capable of creating resistance to antibiotics and multi-resistance.
A recent study reveals that out of 259 strains of L. monocytogenes, 145 had resistance to multiple drugs, being mainly resistant to daptomycin, tigecycline, tetracycline, ciprofloxacin, ceftriaxone, trimethoprim / sulfamethoxazole and gentamicin.
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