Neonatal Listeriosis - Symptoms, Diagnosis, and Treatment

Introduction

Listeriosis is a bacterial infection caused by Listeria monocytogenes, which develop inside the host's cells. It is a gram-positive bacteria that can cause high-risk foodborne listeriosis infections in 30 % of newborns. The bacteria is also one of the primary causes of meningitis in neonates. Listeriosis mainly affects pregnant women through contaminated food and can cause fatal consequences in fetuses and neonates, such as stillbirths, abortions, neonatal sepsis, and premature delivery. However, listeriosis is a rare condition that mildly affects women but can cause fatal effects in the fetus and newborn. Therefore, the article discusses the neonatal listeriosis condition and how it can be diagnosed, treated, and prevented.

What Are the Types of Neonatal Listeriosis?

Early-onset Neonatal Listeriosis:

This usually occurs in less than five days of birth or within 1 to 2 days and is more like septicemia. It causes low birth weight deliveries and may occur with mild transplacental infections from the mother’s genital tract. It causes premature deliveries, and the mortality rate of newborns with early-onset neonatal listeriosis is 20 to 30 percent. It causes multi-organ involvement and obstetric complications. It can be diagnosed with maternal listeria culture.

Late-onset Neonatal Listeriosis:

This occurs in babies after 14 days of birth or more than five days of life and presents symptoms like meningitis. It cannot be diagnosed through maternal listeria culture. The mothers are usually asymptomatic and test negative for culture tests. Late-onset neonatal listeriosis causes normal birth weight deliveries. In this case, the mortality rate is almost 20 %, but it can be further reduced with adequate diagnosis and treatment.

What Are the Causes of Neonatal Listeriosis?

Listeriosis is a bacterial infection caused by Listeria. The bacteria is most commonly found in humans by ingesting infected food. Foods that can cause infections include unpasteurized dail meat and caramel apples.

Listeriosis mainly occurs in people with poor immunity, and healthy adults are less likely to get affected. The risk of listeriosis is more commonly associated with the following:

• AIDS (acquired immunodeficiency syndrome).

• Age above 65 years.

• Diabetes.

• Chemotherapy.

• Medication for rheumatoid arthritis.

• Immunosuppressant drugs.

• Cirrhosis.

• Existing kidney disease.

• Surgical treatment of spleen.

What Are the Symptoms of Neonatal Listeriosis?

The symptoms caused by listeriosis infections are much more likely to develop in pregnant women. They sometimes do not show any signs of the condition, but the fetus can get severely affected by listeriosis infections. The condition can also cause premature birth or miscarriage, and the neonate or newborn may develop a possible life-threatening infection anytime after birth. The symptoms of listeriosis infections in neonates include

• Fever.

• Irritability.

• Lost interest in feeding.

• Vomiting.

• Breathing difficulties.

What Are the Risk Factors for Listeriosis Infection?

The risk factors for listeriosis infections are as follows:

People With Weak Immunity, Such As

• Those having AIDS (acquired immunodeficiency syndrome).

• Who are 65 years and above.

• Are suffering from kidney disorders.

• Have diabetes.

• Those who are on medications for rheumatoid arthritis.

• Those who are on medications for blocking the rejections of an organ transplant.

Pregnant Women and Neonates

Pregnant women are more susceptible to listeria infections as compared to other populations, and it may affect their babies in the following ways:

• Premature birth.

• Miscarriage.

• Fatal infections in babies post birth.

• Stillbirths.

How Is Neonatal Listeriosis Diagnosed?

Neonatal listeriosis can be diagnosed by culturing the bacteria from a sterile site, such as spinal fluid, blood, amniotic fluid or placenta, and urine. Stool and vaginal cultures are not very effective in diagnosing listeriosis infections. Neonatal listeriosis can cause meningitis, sepsis, and pneumonia in newborns and, therefore, should be diagnosed and treated as soon as possible.

Since listeriosis mainly affects pregnancies and can cause severe consequences, thus making the diagnosis challenging. Therefore, doctors should perform blood culture tests on pregnant mothers showing gastrointestinal symptoms and fever. The treatment should be planned immediately if the test results are positive for listeriosis infections.

How Is Neonatal Listeriosis Treated?

Treatment in Pregnancy- Listeriosis is treated with antibacterial medication to prevent the spread of infection or disease in infants and newborns. In addition, Ampicillin, Penicillin, and Amoxicillin can be used to treat listeriosis. High doses of these medications are given to the pregnant mother for adequate penetration into the placenta or umbilical cord. Ampicillin (6 grams) is considered the most effective medication with maximum placental penetration to treat listeriosis.

Treatment in Newborns- The newborns are also treated with antibacterial drugs such as Ampicillin and aminoglycoside for listeriosis. The medication is usually prescribed for 14 days, but if meningitis occurs, the medication is given for 21 days. In addition, other drugs, such as Penicillin or Ampicillin with Trimethoprim or Sulfamethoxazole, can also be prescribed.

What Are the Preventions for Listeriosis Infection in Neonates?

The preventions for listeriosis infections include

• Avoid unpasteurized dairy products and raw vegetables.

• Pregnant women should also avoid processed deli meat and raw salads.

• Canned and refrigerated cheese and meat spreads should also be avoided during pregnancy.

• Wash or scrub the raw vegetables properly and cook them well before eating.

• Smoked and refrigerated seafood is also recommended to be avoided by pregnant women.

• In addition, utensils and the cooking area should be kept clean. Also, engage in hygienic activities like washing hands before preparing, eating, or handling food.

• The doctors should immediately treat infections caused during pregnancies before intrapartum or delivery to minimize the risk of vertical transmission of infection from mother to newborn.

Conclusion

Neonatal listeriosis is a challenging condition to diagnose and treat. It can affect the baby during the gestation phase and post-delivery also. However, the conditions do not cause severe symptoms in pregnant women, but existing comorbidities like diabetes or HIV (human immunodeficiency virus) can cause high-risk infections. Therefore, the doctor must recommend blood culture tests to females showing symptoms of fever or gastrointestinal disorders. Also, the treatment for the same should be started as early as possible to prevent its spread in the newborn. Neonates affected with listeriosis infections can be treated with antibacterial therapy, and the mortality rates can be reduced to less than 20 percent with adequate treatment and diagnostic procedures. In addition, following proper preventive measures can also reduce the risk of listeriosis in neonates.