Listeriosis in newborns can be acquired in the womb or during or after delivery.
Symptoms vary but may include listlessness and poor feeding.
The diagnosis is confirmed by identifying the bacteria in a sample of blood or other material taken from the newborn and mother.
Some newborns die from the infection.
Pregnant women should avoid certain foods and properly wash their hands and kitchen equipment after handling uncooked foods.
Antibiotics can cure the infection.
(See also Overview of Infections in Newborns Overview of Infections in Newborns Infections occur at all ages but are a great cause for concern in newborns because newborns, especially premature ones, have an underdeveloped immune system and are more susceptible to infection... read more and Listeriosis Listeriosis Listeriosis is infection caused by the gram-positive bacteria Listeria monocytogenes, usually when contaminated food is eaten. People may consume the bacteria in contaminated dairy products... read more in adults.)
The Listeria monocytogenes bacteria resides in the intestine of some people and many animals worldwide. Unlike many other organisms, it survives well at refrigerator temperatures.
Pregnant women can become infected if they eat contaminated food. These foods include unpasteurized dairy products, soft cheeses, raw vegetables, prepared deli meats and salads, refrigerated meat spreads, or smoked seafood. Fetuses become infected if Listeria monocytogenes crosses the placenta (the organ that provides nourishment to the fetus) during pregnancy. Newborns may become infected during or after delivery.
Symptoms of Listeriosis in Newborns
Pregnant women with listeriosis may show no symptoms, or they may have symptoms resembling the flu (for example, chills, fever, and muscle aches).
In fetuses and newborns, symptoms of listeriosis are like those of sepsis Sepsis in Newborns Sepsis is a serious bodywide reaction to infection spread through the blood. Newborns with sepsis appear generally ill—they are listless, do not feed well, often have a gray color, and may have... read more (a blood infection) and include listlessness and poor feeding. Symptoms may appear within hours or days of birth (called early onset) or may be delayed up to several weeks (called late onset). Newborns who have symptoms that appear early frequently have a low birth weight, problems at delivery, and symptoms of sepsis soon after birth. Newborns who have symptoms that appear late are usually full-term and initially healthy but then develop meningitis Meningitis in Children Bacterial meningitis is a serious infection of the layers of tissue covering the brain and spinal cord (meninges). Bacterial meningitis in older infants and children usually results from bacteria... read more (a brain infection) or sepsis.
Other common complications of listeriosis include miscarriage Miscarriage A miscarriage is the loss of a fetus due to natural causes before 20 weeks of pregnancy. Miscarriages may occur because of a problem in the fetus (such as a genetic disorder or birth defect)... read more , premature delivery Premature Newborn A premature newborn is a baby delivered before 37 weeks of gestation. Depending on when they are born, premature newborns have underdeveloped organs, which may not be ready to function outside... read more with intra-amniotic infection Intra-Amniotic Infection Intra-amniotic infection is infection of the tissues around the fetus, such as the fluid that surrounds the fetus (amniotic fluid), the placenta, the membranes around the fetus, or a combination... read more , and stillbirth Stillbirth Stillbirth is death of a fetus after 20 weeks of pregnancy. Pregnancy complications are problems that occur only during pregnancy. They may affect the woman, the fetus, or both and may occur... read more .
Diagnosis of Listeriosis in Newborns
Testing of blood and other fluids taken from pregnant women and newborns
In pregnant women who have a fever, samples of blood, material from the cervix, and amniotic fluid may be removed and tested for Listeria monocytogenes.
If a newborn is sick, samples of blood and spinal fluid (obtained with a spinal tap—see figure How a Spinal Tap Is Done How a Spinal Tap Is Done Low-pressure headaches result when cerebrospinal fluid is removed during a spinal tap (lumbar puncture) or leaks out because of a cyst or tear in one of the layers of tissues that cover the... read more ) are collected and tested for Listeria monocytogenes. If a newborn is sick and the mother definitely had listeriosis, samples of blood and spinal fluid in addition to fluid from the stomach, meconium (fecal material that is produced in the intestine before birth), and infected tissues are also collected and tested for Listeria monocytogenes.
The samples are sent to a laboratory to grow (culture) the bacteria or to undergo the polymerase chain reaction Polymerase chain reaction (PCR) Genetic diagnostic technologies are scientific methods that are used to understand and evaluate an organism's genes. (See also Genes and Chromosomes.) Genes are segments of deoxyribonucleic... read more (PCR) test. The PCR test looks for the genetic material of the bacteria and enables doctors to rapidly identify the bacteria. Identifying the bacteria in a sample confirms the diagnosis.
Prognosis of Listeriosis in Newborns
About 10 to 50% of newborns with listeriosis die. The death rate is higher among newborns who have early-onset listeriosis.
Prevention of Listeriosis in Newborns
Pregnant women should avoid the types of foods that are more likely to be contaminated by Listeria monocytogenes. Foods to avoid include unpasteurized dairy products, soft cheeses, raw vegetables, prepared deli meats and salads, refrigerated meat spreads, and smoked seafood. Proper food handling, in particular separating uncooked meats from other items during preparation, and washing hands, utensils, and cutting boards after handling uncooked foods are critical.
If listeriosis is diagnosed during pregnancy, doctors may treat pregnant women before delivery or at delivery with antibiotics to help prevent transmission, but the usefulness of such treatment is unproved.
Treatment of Listeriosis in Newborns
Newborns are given the antibiotic ampicillin plus another antibiotic from the class of drugs called aminoglycosides Aminoglycosides Aminoglycosides are a class of antibiotics used to treat serious bacterial infections, such as those caused by gram-negative bacteria (especially Pseudomonas aeruginosa). Aminoglycosides include... read more . Newborns who also have sepsis require antibiotics and other treatments Treatment Sepsis is a serious bodywide reaction to infection spread through the blood. Newborns with sepsis appear generally ill—they are listless, do not feed well, often have a gray color, and may have... read more .