The drug of choice by virtually all authorities in the field - based on in vitro data, animal models and a small clinical experience. The evidence that it is superior to penicillin is not convincing. The evidence that it is better than cephalosporins is very convincing. Ampicillin is allegedly bacteriostatic to Listeria and this is the reason many advocate the addition of an aminoglycoside. IV amoxicillin available outside of US and used in place of ampicillin
Cephalosporins do not have activity against Listeria. This is important to remember in the empiric selection of drugs for pyogenic meningitis.
Often added to ampicillin to achieve synergy. It is not clear that this is necessary.
Good in vitro activity, but very limited clinical experience and dangerous for monotherapy of any infection. OK to add.
Comment: Large prospective study of invasive listeriosis in France. Detailed picture of clinical manifestations and outcomes provided in this important study. Evidence provided that dexamethasone is associated with worse outcomes
Comment: Updated guidelines on bacterial meningitis that include etiologies of CNS infection (including Listeria) in different age groups and provide treatment recommendations.
Comment: Recommendations regarding pregnant women who are exposed to Listeria. Presumptive testing and treatment recommended.
Comment: IDSA Guidelines for meningitis: For L. monocytogenesmeningitis - preferred is Penicillin G or ampicillin (consider adding gentamicin ). Alternatives are TMP-SMX or meropenem . Doses: Amp - 12gm/d, gent 5mg/kg/d, TMP-SMX 10-20mg/kg (TMP)/d.
Comment: Keep ready-to-eat food cold
Comment: Report of multiple outbreaks of listeriosis associated with consumption of soft cheeses. Highest risk are Latin-style cheeses.
Comment: Review of mechanisms by which Listeria is able to adapt to a range of environmental conditions, and the impact that this adapatibiity has upon acquisition of infection in humans
Comment: This study compared risk factors for Listeria meningitis with those for peumococcal meningitis. Reciept of an immunosuppressive agent and liver disease where independently associated with listeriosis.
Comment: Pulsed-field gel electrophoresis was used to facilitate control of Listeria in a food production facility.
Comment: Outbreak of listeriosis from contaminated cheese from multiple sources. Molecular analysis connected multiple cheese sources possibly due to cross-contamination.
Comment: The review from France includes listerosis in 606 listeria infections. Outcome showed fetal loss in 27% and live-born neonatal listerosis in 58%, and premature birth in 14%.
Comment: Major risk was infliximab based on FDA records showing 266 cases of listeriosis in patients getting biologies. Mortality rates: 11-27%.
Comment: Review of reported listeria to the CDC for 2009-2011 (n=1,651) 14% pregnant, 74% had immunosuppression from malignancy or treatment. Soft cheese was the most common source.
Comment: The review was 1959 cases of listerosis in France from 2001-2008. Risk was >1000 fold with chronic lymphocytic leukemia; risk was 100-1000 fold with liver cancer, myeloma, acute leukemia, giant cell arteritis, organ transplantation and pregnancy.
Comment: Authors review 43 cases of L. monocytogenes bone and joint infections. The most common treatment was amoxicillin (80%) with aminoglycosides (48%) for a median of 15 weeks. Prosthetic joints accounted for 36 (84%) at a median of 9 years post insertion.
Comment: Review of gene sequence during outbreak investigation.
Comment: CDC review of non-outbreak cases in 249 patients. New food sources -- melons and hummus.
Comment: Review of 30 cases of Listeria meningitis - all were immunocompromised or >50yrs. Gram stain of CSF was pos in 7/25 (28%), Mortality 5/30 (17%).
Comment: Review 7,775 stools submitted for culture - 17 yielded L. monocytogenes. PFGE showed no clusters. Cases tended to have pre-existing GI conditions. Recommendation is to not culture stool for Listeria.
Comment: Review of 7 outbreaks of foodborne gastroenteritis due to L. monocytogenes . Symptoms occur 24 hrs after ingestion of large inoculum with fever, watery diarrhea, nausea, headache and arthralgias. Most cases clear within 2 days and don't require antibiotics; consider ampicillin or TMP-SMX in susceptible hosts.
Comment: Analysis of 861 bulk tank milk from 21 states showed Listeria in 56 (6.5%); of these 93% were serotypes commonly found in human disease.
Comment: The authors describe A NEW VIRULENCE FACTOR for L. monocytogenes - a surface protein that binds to E - cadherin of enterocytes which is a necessary step for translocation.
Comment: Outbreak of L. monocytogenes as cause of FOODBORNE OUTBREAK among 60 attendees at a Holstein cow show ascribed to post-pasteurization contamination of chocolate milk. Attack rate was 75%; symptoms were diarrhea 79%, fever 72% and chills 65%. The median incubation period was 20hrs and median duration of diarrhea 42hrs. Contamination level was up to 3x10" bacteria/person.
Comment: This is a BRAINSTEM ENCEPHALITIS which is an unusual CNS complication of Listeria that occurs in previously healthy adults. It is analogous to "circling disease" in sheep. Clinical features are biphasic: fever, headache, nausea & vomiting, lasting several days and then cerebellar signs: cranial nerve deficits & hemiparesis. CSF shows increased protein & WBC; culture is positive in 50%. MRI shows rhomboencephalitis.
Comment: This review showed L. monocytogenes accounted for 29 (11%) of 253 cases of community-acquired MENINGITIS and had a mortality rate of 21%.
Comment: Infection in PREGNANCY usually occurs in 3rd trimester, 22% result in stillbirth, susceptibility presumed to be due to compromised CMI of pregnancy, maternal meningitis is rare & early therapy is often effective in protecting the infant.
Comment: Listeria accounts for about 7% of ENDOCARDITIS cases in adults, usually in patients with pre-existing valve disease. The mortality rate in this review was 48%.
Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. Complete Product Information.