Listeriosis in humans - what is it, symptoms. Treatment of listeriosis in pregnant women. Necessary research to identify the disease

Listeriosis is a zoonotic infectious disease caused by bacteria of the genus Listeria and characterized by polymorphism of clinical phenomena. Cases of listeriosis are recorded on all continents. On the territory of the Russian Federation, listeriosis affects approximately 50-80 people a year. Outbreaks of the disease periodically occur in European countries. For example, in August 2014, an outbreak of listeriosis caused by the consumption of contaminated sausage roll was recorded in Denmark, as a result of which 41 people fell ill. Unfortunately, seventeen people died. In May 2015, a new outbreak occurred in the same country, which left five people ill and two dead.

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Listeriosis in humans is caused by the bacterium Listeria monocytogene. Bacteria are very stable in the external environment and can persist for a long time in soil, water, and food. Listeria is ubiquitous, but not all people who come into contact with the bacteria develop acute form listeriosis. Young children, the elderly, pregnant women, and people with immunodeficiency conditions are at risk of developing the disease.

Sources of infection are sick wild (rodents, hares, foxes, wild boars), agricultural (sheep, goats, pigs), domestic animals (dogs, cats), as well as birds (chickens, geese, ducks, turkeys, parrots, canaries, parrots ). An infected animal with secretions infects the environment.

Listeria is introduced through the mucous membranes of the tonsils, organs of the digestive and respiratory tracts, conjunctiva, damaged skin. Then Listeria are spread by lymphogenous or hematogenous way. Bacteria migrate through lymphatic vessels to regional lymph nodes. Here the immune system tries to stop, localize the infection and for this it produces immune cells. Bacteria can spread to more distant lymph nodes, as well as to the tonsils, spleen and liver.

If the immune system fails to stop the infection, Listeria is carried throughout the body through the blood. Bacteria can settle in any organs, in particular, in the brain. In the affected organs, listeriomas are formed - sites of tissue destruction containing immune cells and listeria.

Symptoms of listeriosis

The incubation period lasts from two to four weeks. The state of the immune system determines the course of the disease. So, in many people the disease occurs in a latent (chronic) form. At chronic form listeriosis bacteria are long-term in human body, but do not cause specific clinical manifestations. Periodic exacerbations of the type of mild flu-like conditions or chronic are possible.

Against the background of a weak immune response, listeria damage various organs, sepsis develops. There are the following forms of listeriosis:

Anginal-septic;
Oculo-glandular;
nervous;
Typhoid;
Listeriosis of pregnant women;

This form of listeriosis is the most common. The disease begins with a sudden increase in temperature, weakness, muscle pain. The patient complains of swallowing. On examination, it is possible to visualize redness of the throat, swelling of the tonsils, which indicates catarrhal angina.

If it is possible to detect grayish membranous raids on the tonsils, ulcers, then we are talking about ulcerative membranous angina. This form of angina is more severe: intoxication syndrome more pronounced, the temperature reaches 39-40 degrees. There is an increase in the cervical, mandibular lymph nodes.

If left untreated, Listeria enters the bloodstream and spreads throughout the body. This condition is called sepsis. The body temperature exceeds 40 degrees, the person is very weak, lethargic. It is noteworthy that the temperature can either rise or fall. Patients are concerned about a runny nose, cough, whitish plaque on the tonsils. There is an increase different groups lymph nodes, as well as the liver and spleen. Single or multiple red rashes appear on the skin, thickening near large joints.

Sometimes the leading symptoms of the disease in humans are fever, rash, hepatosplenomegaly. In this case, they speak of a typhoid-like form of listeriosis.

This form of the disease develops if the conjunctiva of the eyes served as the entrance gate for the infection. One or both eyes may be affected. Against the backdrop of high temperatures, general weakness eye damage develops by type. There is swelling of the eyes, narrowing palpebral fissure, there may be lacrimation, purulent discharge from the eye. Patients complain of redness and dry eyes. In addition, there is a deterioration in vision, patients say that they see everything through the fog. There is an increase in the parotid and cervical lymph nodes.

Damage to the nervous system occurs when Listeria monocytogene penetrates the blood-brain barrier. It occurs in approximately 5-10% of patients with listeriosis, among whom are mainly children. The nervous form is manifested by meningeal, meningoencephalitic and encephalitic syndromes. The most characteristic symptoms:

There are also signs typical of listeriosis: fever, swollen lymph nodes, liver, spleen.

As a rule, in pregnant women, the infection is latent or mild. Possible signs listeriosis in pregnant women:

That is, the symptoms of the disease are absolutely non-specific and are often regarded as manifestations of SARS. Because of this, the disease is not detected on time and, accordingly, the pregnant woman is not treated. Listeria render pernicious influence on fetal development. Mothers infected with listeria have miscarriages, stillbirths, and the birth of children with congenital listeriosis.

In newborns, the disease is severe and often fatal. The baby has a body temperature in the range of 38-39 degrees, a lesion bronchopulmonary system according to the type of bronchopneumonia, accompanied by shortness of breath, apnea, cyanosis, development is possible purulent pleurisy. Splenomegaly is observed, jaundice appears already in the first day of life. Some children develop meningeal symptoms, convulsions, paralysis. An exanthematous rash appears on the skin of the trunk and extremities. At first, the rash can be characterized as spots, which then transform into papules and vesicles.

In 15-20% of recovered children, symptoms remain in the future.

To make a diagnosis of listeriosis, you need to rely on the patient's symptoms and complaints, epidemiological history data. Laboratory and instrumental studies will help confirm the diagnosis:

(characterized by leukocytosis, an increase in the number of monocytes, an acceleration of ESR, a decrease in platelets);
Analysis cerebrospinal fluid(increased pressure, lymphocytic-neutrophilic or neutrophilic pleocytosis, increased protein levels);
Bacterial seeding of the patient's biomaterial (mucus from the throat, blood, cerebrospinal fluid, discharge from the eyes, urine, lymph node biopsies);
PCR (detection of DNA fragments of listeria);
Serological methods: ELISA, RA, RNGA, RSK (allows you to determine specific antibodies to Listeria).

Treatment of listeriosis should be carried out in a hospital setting. The basis of therapy is the appointment of antibacterial agents. Ideally, the antibiotic is prescribed taking into account the result of the sensitivity of Listeria to a particular drug. In practice, antibiotics are prescribed empirically, since it is impractical to wait until bacterial colonies grow - it is necessary to start treatment as early as possible.

In the treatment of listeriosis, antibiotics from the groups of penicillins, tetracyclines, macrolides, aminoglycosides, sulfonamides are used. The duration of admission is 14-21 days.

Given the presence of bacteremia, the patient should definitely undergo detoxification therapy. For this purpose, solutions of sodium chloride, glucose, sodium bicarbonate, potassium and calcium chloride are used. In the presence of cerebral edema, furosemide is prescribed. At severe course listeriosis resort to the appointment of glucocorticosteroids.

Prevention

Since the main route of transmission of listeriosis is alimentary, the quality of the foods consumed should be carefully monitored. You can only eat well-thermally processed meat, fish, poultry, milk, eggs. Pasteurized milk, semi-finished products, sausages should be avoided. Vegetables and fruits should be thoroughly washed.

You can get listeriosis by drinking contaminated water, so you should only drink purified water.

Clean cutting boards and knives. Raw meat should be stored separately from prepared foods.

Listeriosis is also transmitted by contact, so it is better to limit contact with wild, stray animals and birds. It is especially important to explain the danger of such contact to children. Remember that rodents are a particular danger, so you need to carry out deratization measures.

Persons who work at meat processing plants, agricultural enterprises should use individual funds protection.

Grigorova Valeria, medical commentator

There is conflicting information regarding the incidence of listeriosis in pregnant women. According to Breuning and Fritzsche, among 3246 children born, the death rate from listeriosis (well-established) is 0.154%, and according to Alex, for 6000 children - 2%.

Cech and Sima, examining women with a burdened obstetric history, found the presence of listeriosis in 7.6% of cases. On a similar contingent of pregnant women, L. D. Yartseva revealed listeriosis in 9%. Approximately the same figures were obtained by N. N. Yevtushenko. A. S. Ershova in women with a history of miscarriages, established positive serological reactions for listeriosis in 15.4% of cases.

The significance of listeriosis for the course and outcome of pregnancy was largely revealed by the works of Potel, Seeliger, Flamm, P. P. Sakharov and E. I. Gudkova and a number of other researchers. The causative agent of the disease is a bacterium called Listeria monocytogenes. Of great interest are the data obtained by G. V. Brodsky during experimental oral infection of rabbits with Listeria culture. Intrauterine damage to the fetus by this infection was observed with a long (up to 7 months) interval between the time of infection and the time of pregnancy. In the same rabbits, during repeated pregnancy, fetal disease occurred, and in a number of observations focal changes in the internal organs it was even more pronounced than in the fetus during the first pregnancy.

Listeriosis occurs in rodents, insectivores, pigs, sheep, goats, large cattle, horses, foxes, dogs, cats and birds. Infection can occur from eating milk and meat of animals with listeriosis, as well as other infected foods. It is believed that the infection is not transmitted from person to person (except for intrauterine infection of the fetus). However, the possibility of listeria infection of the amniotic fluid, as well as the release of the pathogen with meconium, is a known danger to the attendants and to the health of newborns. This should be taken into account in daily work in an obstetric hospital.

Infection is also possible by inhalation of infected dust, with food (chicken eggs, where Listeria multiply without spoiling them), as well as when working with skins, shoes, animal skins, at a soap factory.

The entrance gates of listeriosis infection are the mouth and nasopharynx, tonsils, conjunctiva of the eye and digestive tract; the possibility of infection through the genital tract is allowed (although this route of infection has not yet been confirmed in the experiment). Later, through the lymphatic tract, Listeria can enter the bloodstream, causing bacteremia and sepsis with damage to the central nervous system, various organs, placenta and fetus (during pregnancy).

Most authors believe that infection with listeriosis intrauterine fetus it is possible only from the time of the formation of the placental circulation, i.e. from about the 5th month of pregnancy. However, practice refutes this opinion and shows that infection is possible at any stage of pregnancy. A pregnant woman is much more likely to develop listeriosis than a non-pregnant woman, for the reason that, as animal experiments have shown, there is a true organotropism of Listeria to the pregnant uterus and placenta. It is also believed that there is toxic effect causative agent, since after infection of animals, an abortion can occur within a few hours. A number of factors contribute to the development of listeriosis - starvation, young or advanced age, organic diseases, etc. Some authors distinguish between "primary" and "secondary" listeriosis, layered on other diseases.

Pregnancy reduces not only local resistance urinary tract, but also general resistance to infection; harmless to a non-pregnant animal, amounts of listeria during pregnancy can also cause a lethal infection in them.

There are 4 clinical forms of listeriosis: 1) anginal-septic; 2) nervous; 3) septic-granulomatous (in fetuses and newborns); 4) oculo-glandular. The disease can be acute, subacute, chronic and abortive. Almost as a rule, in obstetrics one has to deal with a latent infection. When making a diagnosis of listeriosis in pregnant women, the data of the clinic, anamnesis, epidemiological features and laboratory results.

The symptomatology of listeriosis is not the same for different clinical form illness. In pregnant women special attention deserve banal "influenza" phenomena, repeated pyelitis and aggravated obstetric anamnesis: spontaneous premature termination of pregnancy, stillbirth, early infant mortality of newborns and anomalies in the development of the fetus.

Sometimes in pregnant women, the disease is manifested by diarrhea, asthma attacks, sudden fever and chills. In childbirth, colored, dirty amniotic fluid, weakness are often observed. labor activity, and after childbirth individual women- baldness. Fever is often observed a few hours before delivery or during childbirth, which may be a reaction of the mother's body to an infectious focus in the uterus (infected placenta and fetus). After delivery, the temperature usually returns to normal.

A. S. Chistovich during the examination of 50 pregnant women and puerperas with listeriosis, symptoms were found in 16 organic damage brain and 15 - asthenic condition with a neurotic component.

In children born alive with listeriosis, a clinical picture of sepsis is sometimes found, sometimes - aspiration pneumonia, and on x-ray of the skull - calcifications in the brain. On the skin, there is often a hemorrhagic rash in the form of roseola or small nodular formations of a pinkish or bluish color. Almost as a rule, the temperature is raised. Sometimes, there is an increase in the liver and spleen, there are phenomena of meningoencephalitis, respiratory disorders, cyanosis, deafness of heart tones. Clinical picture disease often reminds intracranial injury with the only difference that the phenomena of intoxication, and not the symptoms of arousal, come to the fore.

Laboratory diagnosis of listeriosis is as follows:

1. Detection of listeria in crops from the discharge of the conjunctiva, pharynx, nasopharynx, secretions from the genital tract and other areas of the primary introduction of the infection; Listeria was also found in the blood postpartum hemorrhage, in the urine of pregnant women, in meconium in newborns, in amniotic fluid, in lochia, in the placenta, in scrapings from the uterus, in the organs of the fetus, especially in the brain.

2. In blood tests, monocytosis, mononucleosis (lymphocytosis), leukocytosis, a shift of the leukocyte formula to the left, a decrease in the percentage of polynuclear cells can be detected.

3. In the cerebrospinal fluid, cytosis is noted, mainly due to lymphocytes, in the cerebrospinal fluid culture - the growth of a Listeria culture; there is a decrease in sugar in the cerebrospinal fluid.

4. With pathoanatomical and histological studies the most significant changes are found in the liver, spleen, lymph nodes, heart, central nervous system and meninges, uterus (placenta) and in the internal organs of newborns. Characteristic is the detection of the so-called listeriomas - grayish-white or yellowish granular nodules, consisting of an accumulation in the center of listeria, partially phagocytosed, and the presence on the periphery of a large number of reticular and mononuclear cells, as well as nuclear detritus. The fetus shows signs of septicemia, often significant changes in the respiratory and digestive tracts and inflammation of the middle ear; in the placenta with listeriosis are observed inflammatory phenomena reaching phlegmonous.

5. Serological diagnosis consists in setting up an agglutination reaction and a complement fixation reaction with a listeriosis antigen. However, the diagnostic evaluation of the results of serological tests encounters great difficulties associated with a variety of antigenic structure pathogen, with the presence of antigenic relationship between Listeria and other types of microorganisms and with specifications the course of reactions. Therefore, it is possible to talk about listeriosis according to serological reactions only approximately and only when positive reaction agglutination and complement binding reaction or repeated studies show an increase in antibody titer by at least two dilutions, and also if the agglutination reaction is positive at a dilution of 1: 400 or more, and the complement binding reaction is at a dilution of 1: 10 or more.

Based on the materials of A.P. Egorova, the following data are diagnostically important serological study: a) the simultaneous presence of O- and H-agglutinins and complement-fixing antibodies; b) a distinct increase in titers in both or one of the reactions; c) with a negative RSK, a distinct increase in O- and H-agglutinins. High antibody titers (1:1600 and above in RA and 1:80 and above in RSK) are observed, as a rule, during the current infection and, therefore, give the right to make a diagnosis. Serological reactions in low titers without additional evidence of listeriosis infection have no diagnostic value.

During pregnancy, a combined treatment of listeriosis with antibiotics and sulfonamides is carried out. The most effective antibiotics of the tetracycline group (aureomycin, terramycin, etc.). They are prescribed for 10 days, after which sulfadimezin is given at 0.5 4 times a day for 7 days. During pregnancy (depending on its duration at the beginning of treatment), from 1 to 3 courses of treatment are carried out, and with repeated courses, only sulfadimezin is prescribed.

Such treatment of patients with listeriosis, carried out by L. D. Yartseva in 112 pregnant women (when comparing its results with complications in the group of untreated 109 pregnant women with listeriosis), reduced the frequency of miscarriage from 44.9 to 8%, i.e. in 5 .6 times, the frequency of perinatal mortality - from 33.7 to 9.1%, i.e. 3.5 times, and the frequency of fetal deformities - from 4.3 to 1.9%, i.e. 2, 5 times. Best Results were obtained from those pregnant women whose treatment was started in the first 3 months of pregnancy.

An international symposium, specially dedicated to it and held in Leipzig, testifies to the great interest in listeriosis. By participating in the work of this symposium, we were able, on the basis of the reports made, to draw a number of conclusions: a) an increase in the number of identified diseases with listeriosis in recent years, primarily in pregnant women and newborns; b) The reservoir of Listeria can be infected sheep and soil. Sheep can become infected with listeriosis when fed silage containing listeria. The noted increase in the number of patients with listeriosis from May to September can be associated with the consumption of vegetables and the introduction of infection with them, especially since recent times there has been an increase in the number of cases of detection of listeria from human stool samples; c) marked high efficiency treatment of listeriosis with ampicillin; d) further comprehensive study of listeriosis is needed with the participation, among other specialists, of veterinarians, immunologists and epidemiologists.

AT modern world man has to face large quantity infectious diseases various etiologies. Unfortunately, many diseases that were considered rare in the past are no longer a curiosity. One such disease is listeriosis. Although they do not get infected very often, they cause a lot of problems. Everyone can face this infection without exception, so it is very important to know how this disease is transmitted, manifested and treated, and how you can protect yourself from it.

Listeriosis in humans - what kind of disease is it

Listeriosis belongs to the class of acute infectious diseases of the category of the most dangerous bacterial sapronoses (zoonoses). Previously, it was classified as a group of infections that affect animals. But in the middle of the last century, they found out that a person can also get sick with it. The disease is characterized by a large number of sources of the pathogen, factors and routes of transmission, a variety of symptoms, damage to the lymph nodes, the central nervous system, and a high degree of mortality.

Listeriosis has several synonyms (they all refer to the same condition)

In some sources, you can find synonyms for the name of the disease (they all denote the same condition):

disease of the Tigris River;
monocytosis;
listerellosis;
neurollosis;
granulomatosis of newborns;
childhood granulomatous sepsis.

The disease is especially dangerous for children and pregnant women. In infants, it passes in an extremely severe form. In women carrying a child, regardless of the gestational age, listeriosis can cause a miscarriage, the birth of a baby infected with listeria, or with severe congenital pathologies.

What is a disease - video

Causes and factors for the development of the disease

The disease is caused by gram-positive anaerobic microorganisms Listeria (Listeria monocytogenes). These are sticks correct form that do not form disputes. They are considered unpretentious acid-resistant organisms, growing remarkably well on the most common nutrient media. Listeria is quite resistant to environment, lead an active life at temperatures from 1 to 45 degrees Celsius and pH values of the environment from 4 to 10. The bacterium dies when boiled for at least five minutes, and it is also unstable to disinfectants.

Listeria - the causative agent of listeriosis

Ways of transmission of infection to humans

The food way of transfer is the use of the infected thermally unprocessed food products, especially if prior to their use they were stored long time in a refrigerator. Of particular danger is dairy (milk, soft cheeses, cottage cheese, cream), meat (meat, sausages, semi-finished products, sausages, especially if all this is in vacuum packaging), fish (fish, semi-finished products) products, any root crops.
The contact route of transmission of Listeria to humans is infection after contact with animals (especially rodents), an infected person or a bacteriocarrier.
With an aerogenic transmission route, Listeria enters the body with inhaled air (this is especially true when you are in hospitals, rooms where animal skins, wool, and so on are processed).
The sexual route consists in infection after sexual intercourse with a sick person or a carrier.
The vertical (transplacental or intranatal) route of transmission is intrauterine infection of the fetus as a result of the transmission of bacteria from the bloodstream from an infected mother, infection of the child during childbirth when passing through the birth canal, or as a result of the sexual route of infection.
The transmissible way of transmission of infection is infection after insect bites (certain types of mosquitoes, flies and ticks).

Contaminated foodstuffs are considered main reason listeriosis infection

Who is at risk?

In today's world, people with listeriosis are rarely affected, but there is a tendency to increase the number of cases in the future. All this is due to the fact that Listeria have adapted to environmental conditions.

The risk group includes:

pregnant women;
newborns and infants;
persons with reduced immunity;
persons suffering from alcoholism;
drug addicts;
persons with immunodeficiency conditions (HIV, AIDS, etc.);
workers of farms, meat processing plants, poultry farms, tanneries and so on;
frail elderly.

It is very dangerous to get listeriosis during pregnancy.

Infection occurs through the introduction of Listeria rods into the mucous membranes. digestive tract, eye, respiratory tract, genital organs, damaged skin, placenta. Where the pathogen has entered human body, gradually develops inflammatory response with involvement in the process of regional lymph nodes. Immune cells begin to intensively absorb foreign agents. Those bacteria that did not die as a result of such a struggle penetrate into cell structures organisms, where they begin to multiply rapidly. With good immunity, the “place of localization” of Listeria is limited to the zone in which they were introduced into the body. If immunity is weakened, bacteria can expand their habitat, spreading with blood and lymph to all human organs and systems.

Symptoms and signs of infection

It should be noted that some unified classification of listeriosis modern medicine does not give, since the disease is characterized by a wide variety of its manifestations.

Specialists distinguish several forms of infection:

septic;
nervous;
glandular;
gastroenterological;
listeriosis of pregnant women;
listeriosis of newborns;
bacteriocarrier.

In addition, according to the course and symptoms, listeriosis is distinguished:

spicy;
subacute;
chronic.

nervous form

The nervous form of the disease is considered the most common, severe and occurs in children under the age of three and adults over 45 years of age. Appears by type meningococcal infection. Symptoms include:

various disturbances of consciousness;
severe headaches that only get worse over time;
an increase in body temperature from subfibrile to high values;
possible increase and "liquefaction" of the stool;
eyelid ptosis;
expansion or narrowing of one of the pupils (typical for meningoencephalitis);
the appearance of convulsions and tremors of the limbs is possible;
paralysis.

Anisocoria (asymmetric pupils)

Always listeriosis meningitis leaves complications in the form of:

encephalopolyneuritis;
hydrocephalus;
dementia;
rhombencephalitis;
spinal cord injury and so on.

It is always difficult for the patient, undulating, and in 30 percent of cases ends lethal outcome.

septic form

The septic form is the most severe, in 60 percent of cases ending in death. It develops gradually or subacutely, starting with catarrhal phenomena (sore throat, perspiration, cutting sensations in the eyes) or dyspeptic manifestations (diarrhea, nausea and vomiting). It manifests itself with symptoms such as:

repeated bouts of chills;
high body temperature and its significant fluctuations;
severe intoxication symptoms;
an increase in the size of the liver and spleen;
the appearance of a septic rash.

The rash most often appears on the extremities

An infected person can die from serious conditions such as:

infectious-toxic shock;
acute respiratory and renal failure;
massive bleeding against the background of the development of DIC.

Gastroenterological form

The gastroenterological form always begins acutely:

very rapid rise in body temperature to high values;
severe symptoms of intoxication;
the appearance of nausea with the development of mild vomiting;
pain in the abdomen, which is cramping in nature;
liquid stool;
increased gas formation;
sharp pain in the abdomen during palpation (especially in the right iliac region).

On palpation, the abdomen is quite painful, especially in the right iliac region.

All this lasts an average of seven days. Mortality in this form is quite high and is 20 percent or more. It is due to the development of an infectious-toxic shock in a patient or the transition of this condition to a nervous or septic form, which are considered the most severe.

glandular form

The glandular form is divided into two variants: anginal-glandular or ocular-glandular.

Anginal glandular variant. Appears:

increase in body temperature values;
severe intoxication symptoms;
an increase in size and a sharp pain in the submandibular lymph nodes;
the appearance of necrotic or membranous tonsillitis;
an increase in the size of the spleen and liver;
a rash may appear on the body.

Filmy angina with anginal-glandular form of the glandular form of listeriosis

Oculo-glandular variant. It is characterized by the appearance of the following phenomena:

purulent conjunctivitis (usually unilateral);
severe swelling of the eyelids;
visual acuity is sharply reduced;
small nodular rash in the conjunctival fold;
an increase in size and a sharp pain in the submandibular lymph nodes.

The appearance of purulent conjunctivitis is characteristic of the oculo-glandular type of the glandular form of listeriosis.

Listeriosis pregnant

Listeriosis in pregnancy is caused by sharp decline immune protection body (which is a natural state during pregnancy). As a rule, the disease is manifested by rather blurred symptoms:

the occurrence of muscle pain;
a slight rise in body temperature;
the appearance of conjunctivitis;
the appearance of catarrhal phenomena in the form of a runny nose, sneezing and coughing.

As a result of these clinical manifestations, listeriosis is often initially confused with respiratory infection. In some, these symptoms are accompanied by signs of inflammation of the urinary or digestive organs. If the disease is acute or chronic, then high risk occurrence serious pathologies miscarriage, severe birth defects development, intrauterine death of the child, and so on.

The disease is always severe in the form of sepsis and is characterized by a 50% mortality rate. With transplacental (intrauterine) infection, the baby is born underweight, premature. After a few hours, his body temperature rises sharply to critical levels, he becomes restless, a papular rash forms on the body, the integument becomes cyanotic, shortness of breath is observed, and convulsive syndrome. The newborn dies severe complications as:

hepatitis A;
purulent;
meningoencephalitis;
intrauterine sepsis;
respiratory distress syndrome;
damage to other organs and systems.

In case of intranatal infection (when passing through infected birth canal) the newborn is outwardly healthy, signs of the disease appear by the seventh - tenth day of life.

Listeriosis of newborns, unfortunately, often ends in the death of a child.

Bacteriocarrier

Bacteriocarrier does not appear in any way. The person himself is not sick, then there is a threat of infecting others.

Diagnosis and differential diagnosis

Unfortunately, due to the "universality" of the symptoms of infection, it can easily be confused with other diseases that are characterized by the same symptoms. Therefore, the diagnosis is based solely on outward signs disease will be wrong.

Diagnosis is based on the detection in the blood of the diseased listeria bacillus and their toxins, as well as antibodies and antigens produced by the body in response to the infection. In addition, mucus from the pharynx and nasal passages, conjunctival pus, amniotic fluid, cerebrospinal fluid, and tissues of the lymph nodes are examined.

Listeriosis can only be detected by laboratory tests.

What kind laboratory research are held:

A general blood test, which reveals anemia, leukocytosis, monocytosis, thrombocytopenia, an increase in the erythrocyte sedimentation rate.
Urinalysis, which may be normal. If the infection affects the kidneys, then the tests will contain protein, mucus, an increase in the number of leukocytes, and red blood cells may appear.
Analysis of cerebrospinal fluid, which is carried out mainly with nervous form listeriosis. The results will show that the liquid is cloudy, in it a large number of leukocytes, elevated protein levels, increased cerebrospinal fluid pressure during puncture, and the presence of listeria is also possible.
Bacteriological inoculation of biomaterial on a nutrient medium. In the presence of Listeria, filamentous blue or blue-green colonies will grow on it. These colonies are then examined under a microscope and then tested for sensitivity to antibiotics.
PCR diagnostics of biomaterial (polymerase chain reaction), which makes it possible to quickly identify the genetic material of Listeria in biological fluids. This method is considered an express method for diagnosing listeriosis and is the most accurate in determining the presence of an infection in a patient, even at the earliest stages of the disease.
Serological methods for the study of biological fluids, such as enzyme-linked immunosorbent assay (ELISA), direct and indirect agglutination test (RA and RNGA), complement fixation test (RCT), which allow to determine the presence of antibodies and antigens to Listeria in the biomaterial.

Listeria on nutrient media grow filamentous blue or blue-green colonies.

Mandatory examinations are subject to:

persons with symptoms of any infectious diseases;
pregnant women;
persons with sepsis of unknown etiology;
persons with meningeal symptoms;
persons who have consumed food of dubious quality;
persons working with animals;
persons with tonsillitis, conjunctivitis or lymphadenitis and others;
newborns underexamined or infected with listeriosis mothers.

Treatment of listeriosis

The specific treatment for listeriosis is antibiotic therapy.

Antibiotic therapy

Need to start as soon as possible antibacterial drugs from the onset of the disease to achieve the desired effect.

With glandular and gastroenteric forms, it is recommended to use antibiotics from the group of penicillins (Ampicillin, Amoxicillin, etc.), tetracyclines (Tetracycline, Doxycycline, etc.), sulfonamides (Co-trimoxazole, etc.) and macrolides (Erythromycin, etc.).

Symptomatic treatment

Symptomatic treatment is used to relieve intoxication, reduce pain syndrome, relieve inflammation and reduce body temperature.

Intoxication is removed by intravenous administration isotonic solution sodium chloride or 5% glucose.

To relieve pain, reduce fever and reduce inflammatory process non-steroidal anti-inflammatory drugs such as Paracetamol, Ketorol, Ibuprofen are used, in severe cases Maybe parenteral administration lytic mixture(Dimedrol, Papaverine, Analgin).

With conjunctivitis, washing the eyes with a sterile solution of isotonic sodium chloride solution is indicated, followed by instillation of Albucid and laying hormonal ointments group of glucocorticosteroids (hydrocortisone, etc.).

Prognosis of treatment and possible complications. Effects

With the glandular form of listeriosis, the prognosis is favorable, an infected person may well get on his feet in two weeks.

In other forms, it is serious and requires competent treatment tactics. Unfortunately, mortality in such cases reaches high values.

After recovery, a person develops strong immunity, but still there is no one hundred percent guarantee that it is impossible to get infected again.

Severe forms of listeriosis affect the central nervous system resulting in conditions such as paralysis, mental retardation, epilepsy and other pathologies. In addition, the infection almost always gives complications to the heart and liver in the form of endocarditis and hepatitis.

Infection prevention

There is no specific prevention of infection with listeriosis. But there are non-specific preventive methods and measures to combat the spread of the disease. They include:

health education work in state institutions;
strict food control;
timely and regular cleaning and disinfection of premises;
regular ventilation of the premises;
compliance with the rules for the neighborhood of products in refrigerators (for example, dairy products should be stored separately from fish and meat);
persons working with animals and livestock products to undergo regular preventive examinations(they may be carriers of the infection);
pregnant women to exclude from the diet thermally unprocessed dairy (milk, soft cheeses, ice cream), fish and meat products, fast foods;
children need to carefully process all food before consumption;
do not buy food purchased in trusted places;

Recently, cases of listeriosis, a disease that rarely causes any complications in a woman, but can be deadly for an unborn child, have become more frequent. Unfortunately, the risk of developing listeriosis in a pregnant woman is many times higher than in a non-pregnant woman. Immunity is not developed, that is, listeriosis can be infected and ill more than once.

Listeriosis is an acute infectious disease caused by a bacterium, listeria. Listeria is found in the environment, water, soil, and can be carried by animals. Almost all types of food can be a source of listeria, but mainly meat pies, unpasteurized dairy products, soft cheeses.

You can get listeriosis through food contaminated with bacteria, poorly washed vegetables and fruits, insufficiently thermally processed meat, and so on. Often food contamination with listeriosis occurs during food production or in catering.

The incubation period of the disease can be up to two months. Outbreaks of listeriosis are more common in summer or late spring, but the possibility of infection always exists.

Listeriosis during pregnancy: symptoms.

The main symptoms of listeriosis during pregnancy are: headache and muscle pain, fever, indigestion, nausea, vomiting, and occasionally seizures and confusion.

However, most often listeriosis in pregnant women occurs as an acute respiratory viral infection or mild intestinal infection. In some cases, the mother may be asymptomatic.

However, the diagnosis of listeriosis is not necessary for all pregnant women. Indications for analysis for listeriosis are: the presence of the symptoms described above, or suspicion of intrauterine infection fetus.

Diagnosis and treatment of listeriosis.

Listeria lives inside cells, making it difficult to diagnose and treat. You should be aware that some women are carriers of Listeria, that is, Listeria is found in stool or vaginal discharge but it does not cause disease. Such carriage does not increase the risk of infection of the child either during pregnancy or during childbirth, only infection from the outside is dangerous.

Diagnosis of listeriosis in a pregnant woman is carried out by blood, and the analysis for IgG antibodies is not informative, bakposev is needed. Also, amniotic (amniotic) fluid can be used for diagnosis.

When confirming a diagnosis, emergency treatment, in some cases, delivery (depending on the duration of pregnancy and the condition of the fetus). Timely treatment can prevent infection in the unborn child.

Treatment is usually long, from two weeks and longer. Antibiotics that are safe enough for pregnant women are prescribed, mainly ampicillin, penicillin or amoxicillin.

Listeriosis during pregnancy: consequences.

Listeriosis can affect the gastrointestinal tract, central nervous system, eyes, lymph nodes, and skin. In a pregnant woman, it is most often mild, but occasionally it can cause meningitis or sepsis. A higher risk of the disease itself and its complications are women with concomitant diseases, for example, diabetes, immunodeficiencies.

The main danger of listeriosis is that it can cross the placenta and infect the amniotic fluid. As a result, the child may be born sick or fall ill shortly after birth.

Listeriosis does not cause malformations, but may cause premature birth, as well as stillbirth or death of a newborn. The consequences of listeriosis during pregnancy can be: prematurity, meningitis, asphyxia, pneumonia, sepsis, fever, jaundice in the newborn.

More than half of the children are completely cured, but there may be long-term neurological complications, as well as blindness, paralysis, kidney and heart problems. Many of the consequences of listeriosis can be avoided if timely diagnosis and treatment are carried out.

How to prevent listeriosis.

Preventing listeriosis during pregnancy is much easier than treating it. To do this, you must follow the following rules.

Wash hands with soap for at least 20 seconds after going to the toilet, before and after preparing food, and before eating.

Cook meat and fish thoroughly. It should be borne in mind that Listeria dies at temperatures above 75 degrees and retains its properties when frozen.

Store ready and raw foods separately. It is also important to use different cutting boards for raw and cooked foods. After cooking meat products wash dishes and surfaces hot water with soap.

In the kitchen, use disposable towels or wash towels frequently with hot water.

Wash fruits and vegetables thoroughly.

Good for reheating leftovers.

Avoid sprouted seeds, unpasteurized milk, soft cheeses (feta, camembert), prepared deli salads, and raw seafood, including sushi.

Control the temperature in your refrigerator and freezer.

In our country, few people know about listeriosis, and yet it can have no less serious consequences than TORCH infection. Fortunately, listeriosis is not difficult to prevent if the entire pregnancy is observed. elementary rules hygiene and food preparation rules. If you suspect listeriosis, you should consult a doctor and conduct an urgent examination and treatment.

Listeriosis during pregnancy is a serious infection that you can get by eating foods contaminated with Listeria bacteria. pregnant women and their developing child as well as newborns, immunocompromised people, and the elderly are particularly susceptible to Listeria, which can cause blood poisoning, meningitis, and other serious and potentially life-threatening complications.

The main threat to a pregnant woman is the devastating impact of this disease on pregnancy and on the child. Fortunately, this disease is relatively rare - about 2500 people are recorded per year, and about 1/3 of them are pregnant women.

The effect of listeriosis on pregnancy

If you get listeriosis at a time when your immune system is not weakened by any other concomitant disease, then the impact of Listeria on your health will be very negligible. But even if the infection does not cause health problems for you, then for your developing child she can have quite serious consequences, especially if it is not cured in time and quickly.

Listeria can infect the placenta, amniotic fluid, and fetus, and can cause miscarriage or stillbirth. Listeria-infected babies who survive are most often born prematurely. Some of these children are already born seriously ill, some become ill some time after birth, but they all face problems that include blood poisoning, difficulty breathing, fever, skin ulcers, lesions internal organs and central nervous system infections such as meningitis.

Some newborns born to infected mothers appear healthy at birth and the first signs of infection (usually the development of meningitis) begin a week or even several weeks after delivery. This so-called "late-onset listeriosis" may be the result of a baby becoming infected during childbirth (infected women have bacteria living in the cervix and vagina), or if transmission was from a source other than the mother. Unfortunately, many infected infants die or suffer lifelong consequences from listeriosis.

Symptoms of listeriosis

Some people don't have any symptoms, so if you get sick listeriosis during pregnancy you may not even know about it. Other people have signs of illness such as fever and other flu-like symptoms (joint pain, chills, headache, and muscle pain), back pain and symptoms of gastrointestinal disorders.

Less commonly, the infection affects the central nervous system. If this happens, the patient's condition becomes extremely severe, and he begins to experience symptoms such as severe headache, rigidity (excessive tone) of the occipital muscles, confusion, dizziness and even convulsions.

Call your doctor immediately if you suspect that you have symptoms of listeriosis. Symptoms associated with gastrointestinal tract, usually appear within 48 hours, but the onset of other symptoms is usually delayed until two to six weeks (or more) after infection. You will need to take blood tests to find out if your symptoms are really due to listeriosis.

Treatment of listeriosis in pregnant women

For the treatment of listeriosis, a woman is prescribed antibiotics, the action of which is aimed at destroying the infection and protecting the child from bacterial infection. As treatment progresses expectant mother several times will be done ultrasound procedure to check how the child is growing and feeling.

Prevention of infection with listeriosis

1. Cook fish, poultry and meat thoroughly . Most meats should be cooked between 71°C and 77°C. If you don't have a special thermometer to measure the temperature of the meat, cook it until it is completely cooked in the middle. Fish until completely opaque throughout the carcass. Do not try half-cooked foods to appreciate their taste - wait until they have undergone a good heat treatment.

2. Reheat food from the refrigerator . Listeria can even appear in well-cooked and processed foods, and unlike many bacteria, it can survive and multiply in the refrigerator. Therefore, if you are reheating dishes prepared yesterday, make sure that the temperature during reheating reaches 70 ° C and that steam comes out of the dish (so that the food is completely warmed up). If you are using a microwave to warm up, cover your plate with a microwave-safe lid. Let the food stand for a few minutes after removing it from the microwave oven to complete the heating process.

3. Avoid store-bought, convenience foods, and culinary products . Try to limit the use of sausage as much as possible and meat delicacies, pates, chilled boiled meat or chilled salted or (fish, poultry, meat) if they are not intended for hot heat treatment(that is, those that need to be eaten cold, in the form in which you bought them). canned food or long-term storage products that are not stored in the refrigerator, but room temperature must be eaten within 2 hours after opening. Avoid prepared salads and other culinary specialties from grocery stores and supermarkets, especially those that contain eggs, chicken or seafood. Also during pregnancy, it is better to give up picnics and barbecue.

4. Avoid raw (unpasteurized) milk . Milk here refers to cow's and goat milk and products made from them. Avoid soft cheeses such as feta, brie, camembert, blue cheese, and Mexican cheeses such as Queso Blanco, Queso Fresca, or Panela, which are made from unpasteurized milk. Cottage cheese, processed cheese and hard cheese are generally considered safe, as are dairy products(sour cream, kefir, fermented baked milk, yogurt, etc.). But in order to be completely safe from listeriosis during pregnancy Read the labels on all dairy products carefully to make sure they are made from pasteurized milk.

5. Wash all foods well before use . Thoroughly wash and peel all fruits and vegetables before eating!

6. Change dish sponge and dishcloths and towels regularly . Keep in mind that rags and sponges can contain bacteria. Wash kitchen towels regularly hot water and at least once a week, replace your dishwashing sponge. Of course, instead of a regular rag towel, it's best to use a disposable paper towel.

7. Don't keep food too long . Perishable and ready-to-eat foods should be eaten as soon as possible after they are opened, even if they have not expired. This period applies only to sealed products.

8. Check the temperature in the refrigerator and freezer . As a precautionary measure to protect food from contamination by various pathogens, make sure that the temperature in your refrigerator is set to no higher than 4°C and that the temperature of the freezer does not exceed 0°C.

Remember that Listeria are extremely hardy organisms that can survive and continue to grow even in low temperatures (albeit more slowly). That is why, for the prevention listeriosis during pregnancy, you should always heat previously cooked meals and ready-to-eat foods until they are very hot. Also, be sure to clean your refrigerator and microwave as often as possible.

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