LISTERIA MONOCYTOGENES                Dr.T.V.Rao MDDR.T.V.RAO MD                   1
WHAT IS LISTERIOSIS• Listeriosis, a serious infection caused by eating  food contaminated with the bacterium Listeria  Mon...
Listeria Monocytogenes is a rod-shaped aerobic and gram positive  pathogenic bacterium that invades the cytoplasm of livin...
LISTERIOSIS• Listeriosis is caused by  Bacterial agent an  intracellular pathogen Listeria Monocytogenes• L.monocytogenes ...
WHO ARE AT RISK WITH LISTERIOSIS• Pregnant women• New-borns• People with weakened  immune systems• People who are taking  ...
LISTERIA MONOCYTOGENES• L.monocytogenes is a Gram +  ve non spore forming.• A specific character of the  organism manifest...
CULTURE AND GROWTH                   CHARACTERISTICS• Grows on Muller Hinton  agar with sheep blood as  enrichment.• Small...
BIOCHEMICAL REACTIONS                      • Bacteria are facultative                        anaerobic microbes           ...
CAMP POSITIVE LISTERIA• CAMP-positive Listeria  monocytogenes inoculated at  right angles to b-hemolytic  Staphylococcus a...
HOW HUMANS CONTACT LISTERIOSIS• Listeria monocytogenes can be found in a variety  of dairy products, vegetables, fish and ...
PATHOGENESIS AND PATHOLOGY• Listeria Monocytogenes enters through the Gastro  – intestinal tract after infections of conta...
WHO ARE AT HIGHER RISK• The following conditions  may be impaired with  defective cell mediated  Immunity   Pregnancy   AI...
CONTAMINATION CAUSES              LISTERIOSIS• Listeria Monocytogenes is   • The bacterium has been  found in soil and wat...
SYMPTOMS• Fever                     • If infection spreads to the• Muscle ache                 nervous system:            ...
COMMON PRESENTINGMANIFESTATION OF LISTERIOSIS• Vomiting;• Nausea;• Cramps;• Diarrhea;• Severe Headache;• Constipation; or•...
LISTERIOSIS IN ADULTS• Adults may present with  bacterimia .  Meingoencephalitis and occur  most commonly in  Immunosupres...
LISTERIOSIS PRESENTING WITH               MENINGITIS• Immunocompromised adults are at risk for a serious  infection of the...
LATE ONSET MANIFESTATIONS• The new born child may  present with late onset  syndrome causes the  development of Meningitis...
LISTERIOSIS AND PREGNANCY• Pregnant women -  They are about 20  times more likely  than other healthy  adults to get  List...
LISTERIOSIS IN NEW BORNS                      • New-borns - New-                        borns rather than                 ...
DIAGNOSIS• There is no routine screening test for  susceptibility.• Patient may present with fever, or stiff  nec, .• A bl...
DIAGNOSIS• Diagnosis  dependent on  isolation of  Organisms in  cultures obtained on  CSF, Blood, and  other fluidsDR.T.V....
TREATMENT• Listeriosis is a serious disease requiring   hospitalization.• A combination of antibiotics is given intravenou...
ANTIBIOTIC TREATMENT• Ampicillin• Erythromycin• Intravenous Trimethoprim – Sulphmethoxazole• Cephalosporins and Fluroquino...
FOODS TO AVOID• Hot dogs, especially straight from  the package without further  heating. The fluid within hot dog  packag...
KEEP YOUR FOOD SAFE –                 AVOID LISTERIOSISDR.T.V.RAO MD                           26
IDEAL WAY TO PREVENT LISTERIOSIS• Completely cook all meats and eggs.• Carefully wash raw vegetables before eating.• Keep ...
• Programme Created by Dr.T.V.Rao MD    for Medical and Health Care Workers in             the Developing World           ...
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Listeria monocytogenes

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Listeria monocytogenes

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Listeria monocytogenes

  1. 1. LISTERIA MONOCYTOGENES Dr.T.V.Rao MDDR.T.V.RAO MD 1
  2. 2. WHAT IS LISTERIOSIS• Listeriosis, a serious infection caused by eating food contaminated with the bacterium Listeria Monocytogenes, has recently been recognized as an important public health problem in the United States. The disease affects primarily persons of advanced age, pregnant women, new-borns, and adults with weakened immune systems. However, persons without these risk factors can also rarely be affected.DR.T.V.RAO MD 2
  3. 3. Listeria Monocytogenes is a rod-shaped aerobic and gram positive pathogenic bacterium that invades the cytoplasm of living cells. It develops a distinctive rocket tail structure to help push through thecytoplasm. Eventually, these "rockets" push bacteria into neighboring cells, propagating the infection DR.T.V.RAO MD 3
  4. 4. LISTERIOSIS• Listeriosis is caused by Bacterial agent an intracellular pathogen Listeria Monocytogenes• L.monocytogenes produces infections world wide• Important cause of infections in animals and man. DR.T.V.RAO MD 4
  5. 5. WHO ARE AT RISK WITH LISTERIOSIS• Pregnant women• New-borns• People with weakened immune systems• People who are taking immuno-suppressing medication.DR.T.V.RAO MD 5
  6. 6. LISTERIA MONOCYTOGENES• L.monocytogenes is a Gram + ve non spore forming.• A specific character of the organism manifest with tumbling end or over end motility at 220c – 280c but not at 370c But makes the Microbiologists to identify from Diptheriods, which are mistaken and specimens are discarded. DR.T.V.RAO MD 6
  7. 7. CULTURE AND GROWTH CHARACTERISTICS• Grows on Muller Hinton agar with sheep blood as enrichment.• Small zone of Hemolysis can be observed around and the underneath of the colony.• Specimens are enriched if the tissues are kept at 40c and plated on the media ( Cold enrichment ) DR.T.V.RAO MD 7
  8. 8. BIOCHEMICAL REACTIONS • Bacteria are facultative anaerobic microbes • Catalase + motile • Listeria produce acid and not gas in various sugar fermentation tests DR.T.V.RAO MD 8
  9. 9. CAMP POSITIVE LISTERIA• CAMP-positive Listeria monocytogenes inoculated at right angles to b-hemolytic Staphylococcus aureus. Note the arrow-shaped zone of weak enhanced hemolysis indicating a positive CAMP test. Gloves are worn when working with L. Monocytogenes. (Anne Hanson, University of Maine) DR.T.V.RAO MD 9
  10. 10. HOW HUMANS CONTACT LISTERIOSIS• Listeria monocytogenes can be found in a variety of dairy products, vegetables, fish and meat products.• Listeria monocytogenes, unlike most other harmful bacteria, will grow slowly on foods stored in a refrigerator.• Listeria monocytogenes can also be spread by contact with an infected product or surface, such as hands or counter tops, during food preparation.DR.T.V.RAO MD 10
  11. 11. PATHOGENESIS AND PATHOLOGY• Listeria Monocytogenes enters through the Gastro – intestinal tract after infections of contaminated foods such as cheese or vegetables,• The cell wall surface protein called Interanalin interacts with E –CADHERIN and enters into epithelial cells• Bacteria produce Listeriolysin• L.monocygenes can move from cell to with out being exposed to Antibodies,Complement,Polymorphonuclear cells DR.T.V.RAO MD 11
  12. 12. WHO ARE AT HIGHER RISK• The following conditions may be impaired with defective cell mediated Immunity Pregnancy AIDS Lymphomas Organ transplant recipients DR.T.V.RAO MD 12
  13. 13. CONTAMINATION CAUSES LISTERIOSIS• Listeria Monocytogenes is • The bacterium has been found in soil and water. found in uncooked meats• Vegetables can become and vegetables, soft contaminated from the cheeses, deli cold-cuts, and soil or from manure used unpasteurized milk or as fertilizer. foods.• Animals can carry the • If acquired at birth, the bacterium without incubation period is 7 to 28 appearing ill and can days. contaminate foods of • The average incubation animal origin such as period is 31 days; with a meats and dairy products. range from 11 to 47 days. DR.T.V.RAO MD 13
  14. 14. SYMPTOMS• Fever • If infection spreads to the• Muscle ache nervous system: headache, stiff• GI Sx: Nausea, diarrhea neck, confusion, loss of• Pregnant women: mild balance, or convulsions. flu-like • Listeria can cause Sx, miscarriage, still birth, premature Pneumonia, Meningitis, a delivery, or infected nd Sepsis. newborn.• Lethargy• irritability DR.T.V.RAO MD 14
  15. 15. COMMON PRESENTINGMANIFESTATION OF LISTERIOSIS• Vomiting;• Nausea;• Cramps;• Diarrhea;• Severe Headache;• Constipation; or• Persistent fever.DR.T.V.RAO MD 15
  16. 16. LISTERIOSIS IN ADULTS• Adults may present with bacterimia . Meingoencephalitis and occur most commonly in Immunosupressed patients in whom Listeria is one of the more common cause of Meningitis• Disease can be insidious to fulminant DR.T.V.RAO MD 16
  17. 17. LISTERIOSIS PRESENTING WITH MENINGITIS• Immunocompromised adults are at risk for a serious infection of the blood stream and central nervous system (brain and spinal cord). Meningitis occurs in about half of the cases of adult Listeriosis. Symptoms of listerial meningitis occur about four days after the flu-like symptoms and include fever, personality change, uncoordinated muscle movement, tremors, muscle contractions, seizures, and slipping in and out of consciousness. DR.T.V.RAO MD 17
  18. 18. LATE ONSET MANIFESTATIONS• The new born child may present with late onset syndrome causes the development of Meningitis between birth and third week of life• It is often caused by serotype IV b and has a significant mortality rate DR.T.V.RAO MD 18
  19. 19. LISTERIOSIS AND PREGNANCY• Pregnant women - They are about 20 times more likely than other healthy adults to get Listeriosis. About one-third of listeriosis cases happen during pregnancy.DR.T.V.RAO MD 19
  20. 20. LISTERIOSIS IN NEW BORNS • New-borns - New- borns rather than the pregnant women themselves suffer the serious effects of infection in pregnancy. DR.T.V.RAO MD 20
  21. 21. DIAGNOSIS• There is no routine screening test for susceptibility.• Patient may present with fever, or stiff nec, .• A blood or spinal fluid examination (to cultivate the bacteria) will confirm the clinical diagnosis. .• During pregnancy, patients need detailed investigations to rule our Listeriosis. 21
  22. 22. DIAGNOSIS• Diagnosis dependent on isolation of Organisms in cultures obtained on CSF, Blood, and other fluidsDR.T.V.RAO MD 22
  23. 23. TREATMENT• Listeriosis is a serious disease requiring hospitalization.• A combination of antibiotics is given intravenously through a small straw-like catheter.• When infection occurs during pregnancy, antibiotics must be given promptly to the mother to prevent infection of the fetus or newborn.• The duration of antibiotic treatment is at least 2 weeks.• Even with prompt treatment, some infections result in death. DR.T.V.RAO MD 23
  24. 24. ANTIBIOTIC TREATMENT• Ampicillin• Erythromycin• Intravenous Trimethoprim – Sulphmethoxazole• Cephalosporins and Fluroquinoles are not active against l.monocytogens• A commination of Gentamycin and Ampicillin on clinical basis DR.T.V.RAO MD 24
  25. 25. FOODS TO AVOID• Hot dogs, especially straight from the package without further heating. The fluid within hot dog packages may contain more Listeria than the hot dogs.• Avoid spreading fluid from packages onto other foods, cutting boards, utensils, dishes and food preparation surfaces. Wash your hands after handling hot dogs.DR.T.V.RAO MD 25
  26. 26. KEEP YOUR FOOD SAFE – AVOID LISTERIOSISDR.T.V.RAO MD 26
  27. 27. IDEAL WAY TO PREVENT LISTERIOSIS• Completely cook all meats and eggs.• Carefully wash raw vegetables before eating.• Keep raw meat away from raw vegetables and prepared foods. After cutting raw meat, wash the cutting board with detergent before using it for vegetables.• Avoid drinking unpasteurized milk or foods made from such milk.• Wash hands thoroughly after handling raw meat.• Follow the instructions on food labels. Observe food expiration dates and storage conditions. DR.T.V.RAO MD 27
  28. 28. • Programme Created by Dr.T.V.Rao MD for Medical and Health Care Workers in the Developing World Email doctortvrao@gmail.comDR.T.V.RAO MD 28
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