Listeria monocytogenes infection in pregnancy: experience of Pontificia Universidad Católica de Chile University Hospital

Abstract

Listeria monocytogenes is Gram-positive facultative intracellular pathogen often foodborne and found elsewhere. It is an uncommon cause of illness in the general population. However, it is an important cause of severe infection in neonates, pregnant women, elderly and immunosuppressed patients. Listeriosis has unique preference for pregnant women. Maternal listeriosis is a diagnostic challenge, and intrauterine infection can lead to severe complications such as amnionitis, preterm labor, spontaneous abortion, stillbirth and neonatal sepsis. From 2001 to 2005, 16 patients with L. monocytogenes were identified in this hospital; four (25%) were pregnant women. Clinical and laboratory findings are described. There were 3 preterm deliveries and 1 spontaneous second trimester abortion. Three women with listeriosis had no predisposing factors other than pregnancy. One patient was on immunosupressive drugs for ulcerative colitis. Fever was the most common symptom. Infected neonates were most commonly diagnosed with early-onset listeriosis (two cases) or fetal demise (one case). Pregnancy can be the only risk factor for listeriosis. Listeriosis should be considered during the evaluation of febrile syndrome in pregnancy as this condition can be the only risk factor. Blood and amniotic fluid cultures are useful diagnostic tests. Perinatal complications remains high.