Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Listeriosis in pregnancy: under-diagnosis despite over-treatment

Abstract

Objective:

To compare the symptomatology of pregnant women with suspected listeriosis to culture confirmed listeriosis.

Study Design:

All cases of suspected and culture confirmed pregnancy-associated listeriosis from a single center were retrospectively reviewed assessing demographics, clinical, laboratory and pathological findings, and maternal, fetal and neonatal outcomes.

Results:

Listeriosis was identified in seven patients, none of whom belonged to the 117 women with suspected listeriosis. Women with confirmed infection were more likely to exhibit fever (P=0.01), flu-like symptoms (P=0.006), threatened preterm labor (P=0.05) and inflammatory markers (P=0.02), but less likely to exhibit gastrointestinal complaints (P=0.004) in comparison with suspected non-confirmed cases. Confirmed cases resulted in preterm delivery (n=5) and stillbirth (n=2). Neonatal complications included meningitis, respiratory disease and sepsis. Maternal outcomes were favorable.

Conclusion:

Although ‘febrile gastroenteritis’ is a poor predictor of listeriosis in pregnancy, fever, premature contractions and inflammatory markers are important risk indices prompting workup and adequate empiric treatment.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1

    Benshushan A, Tsafrir A, Arbel R, Rahav G, Ariel I, Rojansky N . Listeria infection during pregnancy: a 10 year experience. Isr Med Assoc J 2002; 4 (10): 776–780.

    PubMed  Google Scholar 

  2. 2

    Soni DK, Singh DV, Dubey SK . Pregnancy—associated human listeriosis: virulence and genotypic analysis of Listeria monocytogenes from clinical samples. J Microbiol 2015; 53 (9): 653–660.

    CAS  Article  Google Scholar 

  3. 3

    Crim SM, Iwamoto M, Huang JY, Griffin PM, Gilliss D, Tauxe R et al. Preliminary incidence and trends of infection with pathogens transmitted commonly through food—Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2006-2014. MMWR Morb Mortal Wkly Rep 2015; 64 (18): 495–499.

    PubMed  PubMed Central  Google Scholar 

  4. 4

    Silk BJ, Date KA, Pouillot R, Holt KH, Graves LM, Kanyin LO et al. Invasive listeriosis in the Foodborne Diseases Active Surveillance Network (FoodNet), 2004-2009: further targeted prevention needed for higher-risk groups. Clin Infect Dis 2012; 54 (Suppl 5): S396–S404.

    Article  Google Scholar 

  5. 5

    Committee on Obstetric Practice AeCoOaG. Committee Opinion No. 614: Management of pregnant women with presumptive exposure to Listeria monocytogenes. Obstet Gynecol 2014; 124 (6): 1241–1244.

    Article  Google Scholar 

  6. 6

    Hof H . An update on the medical management of listeriosis. Expert Opin Pharmacother 2004; 5 (8): 1727–1735.

    CAS  Article  Google Scholar 

  7. 7

    Lamont RF, Sobel J, Mazaki-Tovi S, Kim SK, Uldbjerg N, Romero R et al. Listeriosis in human pregnancy: a systematic review. J Perinat Med 2011; 39 (3): 227–236.

    Article  Google Scholar 

  8. 8

    Temple ME, Nahata MC . Treatment of listeriosis. Ann Pharmacother 2000; 34 (5): 656–661.

    CAS  Article  Google Scholar 

  9. 9

    Gerner-Smidt P, Ethelberg S, Schiellerup P, Jensen A, Petersen AM, Bruun BG et al. Invasive listeriosis in Denmark 1994-2003: a review of 299 cases with special emphasis on risk factors for mortality. Clin Microbiol Infect 2005; 11 (8): 618–624.

    CAS  Article  Google Scholar 

  10. 10

    Mylonakis E, Paliou M, Hohmann EL, Calderwood SB, Wing EJ . Listeriosis during pregnancy: a case series and review of 222 cases. Medicine (Baltimore) 2002; 81 (4): 260–269.

    Article  Google Scholar 

  11. 11

    Elinav H, Hershko-Klement A, Valinsky L, Jaffe J, Wiseman A, Shimon H et al. Pregnancy-associated listeriosis: clinical characteristics and geospatial analysis of a 10-year period in Israel. Clin Infect Dis 2014; 59 (7): 953–961.

    CAS  Article  Google Scholar 

  12. 12

    Ludvigsson JF . Effect of gastroenteritis during pregnancy on neonatal outcome. Eur J Clin Microbiol Infect Dis 2001; 20 (12): 843–849.

    CAS  Article  Google Scholar 

  13. 13

    Angelo KM, Jackson KA, Wong KK, Hoekstra RM, Jackson BR . Assessment of the incubation period for invasive listeriosis. Clin Infect Dis 2016; 63 (11): 1487–1489.

    Article  Google Scholar 

  14. 14

    Silver HM . Listeriosis during pregnancy. Obstet Gynecol Surv 1998; 53 (12): 737–740.

    CAS  Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to S Shinar.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Fouks, Y., Amit, S., Many, A. et al. Listeriosis in pregnancy: under-diagnosis despite over-treatment. J Perinatol 38, 26–30 (2018). https://doi.org/10.1038/jp.2017.145

Download citation

Further reading

Search

Quick links