Category Archives: INFECTIONS

New Guidelines Respond to Current Public Health Need Following Listeria Warnings

Listeriosis is an infection caused by the bacteria Listeria monocytogenes Listeria  is commonly  found in water, soil, raw , and processed foods. The ability of the Listeria bacteria to grow at temperatures as low as 4°C ( 39 °F ) allows Listeria to multiply in refrigerated foods

Most infections are caused by eating foods contaminated with theListeria bacteria  such as uncooked meats , vegetables (including raw sprouts) , cantaloupes, or soft cheeses  and ice cream made with unpasteurized milk.  Listeriosis may also occur through mother to child to child transmission or cross infection. The incubation period has been reported to be as short as is from 24 hours .However,  periods ranging from 11 to 70 days, with a mean of 31 days Once the bacteria has entered the body it grows and hides within the infected person’s cellsListeria has a predilection for the placenta and central nervous system.

What are the Symptoms of Listeria?

Infected pregnant women may experience no symptoms or flu-like symptoms such as fever, muscle or back pain. Diarrhea and abdominal pain are common. Some women may also experience  intense headache, nausea, vomiting , stiff neck and other signs of meningitis.

Diagnosis of listeria infection is made by culturing the organism from a sterile site such as blood, amniotic fluid, or spinal fluid. Stool culture is not useful. The laboratory should be informed of the suspicion of listeriosis.

Effects on Pregnancy

About one-third of listeriosis cases happen during pregnancy. Listeria infections during pregnancy can lead to miscarriage or stillbirth, premature delivery, or infection of the newborn. The affected fetus may show decreased movement with dilated echogenic bowels (intestines) and ascites on ultrasound examination.

Treatment of Listeria During Pregnancy

The American Congress of Obstetricians and Gynecologists (ACOG) recommends exposed pregnant women “…with a fever higher than 38.1  o C (100.6  o F) and signs and symptoms consistent with listeriosis for whom no other cause of illness is known should be simultaneously tested and treated for presumptive listeriosis.” The treatment of choice is high dose IV ampicillin for at least 14 days. Trimethoprim with sulfamethoxazole (Bactrim , Septra) has been recommended in women who are allergic to penicillin.

ACOG recommends no testing or treatment for asymptomatic pregnant women with no symptoms who report consumption of a product that was recalled for suspected listeria contamination or a product that was implicated in an outbreak of listeria .

The ACOG Committee Opinion “Management of Pregnant Women With Presumptive Exposure to Listeria monocytogenes” is available at :

http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Management-of-Pregnant-Women-With-Presumptive-Exposure-to-Listeria-monocytogenes

Prevention

Women can decrease their chances of getting listeriosis by eating pasteurized foods (such as cheeses and milk) , washing raw fruits and vegetables thoroughly under running tapwater , and avoiding hot dogs, luncheon meats, or deli meats unless they have been properly reheated to steaming ( 160 degrees F.)

REFERENCES

  1. Goulet V, et. al., What is the incubation period for listeriosis? BMC Infect Dis. 2013 Jan 10;13:11. doi: 10.1186/1471-2334-13-11. PMID: 233051742.
  2. Hasbún J, et. al., Chorioamnionitis caused by Listeria monocytogenes: a case report of ultrasound features of fetal infection. Fetal Diagn Ther. 2013;33(4):268-71. doi: 10.1159/000345091. PMID: 23429225
  3. Janakiraman V.Listeriosis in pregnancy: diagnosis, treatment, and prevention. Rev Obstet Gynecol. 2008 Fall;1(4):179-85. PMID: 1917302
  4. Lamont RF, et. al., Listeriosis in human pregnancy: a systematic review. J Perinat Med. 2011 May;39(3):227-36. PMID: 21517700
  5. http://www.cdc.gov/nczved/dfbmd/disease_listing/listeriosis_gi.html

Copyright © 2014 by Focus Information Technology. All rights reserved

Mobile App—Prevent Group B Strep (GBS) Helps Providers Prevent Life-threatening Infections in Newborns

The Mobile App—Prevent Group B Strep (GBS) which was developed by CDC with the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Nurse-Midwives, simplifies the screening process of interpreting the guidelines. The app asks obstetric and neonatal providers to answer a series of simple questions about their patients. Based on the responses, health care providers obtain patient-specific GBS prevention recommendations within seconds. Additionally, the app provides patient-specific recommendations for the appropriate choice of antibiotic for pregnant women, an area of the GBS guidelines that does not always get correctly implemented. Using the right antibiotic is critical, especially in an era of antibiotic resistance.

The App  and a web version are  available at:

http://www.cdc.gov/groupbstrep/guidelines/prevention-app.html

Most Antibiotics Are Safe During Pregnancy

Washington, DC — In 2009, researchers from the National Birth Defects Prevention Study published a report suggesting that two types of commonly prescribed antibiotics used to treat urinary tract infections—nitrofurans and sulfonamides—may increase the risk of birth defects when taken during the first trimester. However, a new Committee Opinion issued today by The American College of Obstetricians and Gynecologists (The College) suggests that these two antibiotics are still considered appropriate when there is no suitable alternative.