Us Ebru, Cengiz A Tevfik, Gelişen Orhan
Ankara Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalil, Ankara.
Mikrobiyol Bul. 2008 Jan;42(1):41-8.
Listeria monocytogenes may lead to intrauterine infections which can be treated if diagnosed promptly. However, there is not a rapid routine screening test with high specificity and sensitivity for the diagnosis of listeriosis during pregnancy. We investigated the presence of different L. monocytogenes O antibodies for diagnosis of listeriosis in 275 paired maternal-cord sera using the agglutination test, and aimed to evaluate the correlation between poor pregnancy outcomes, level of L. monocytogenes serotype O antibodies and risk factors for listeriosis. Maternal-cord bloods were collected from a total of 275 pregnant women (age range 16-38 years) between April-August 2002 from a State Hospital in Ankara. A total of 550 sera were tested against antigens with the O formulation of serotypes 1/2c, 3b, 4ab, 4c, 4d by tube agglutination method and titers > or = 1/320 were considered as positive. Sixtynine patients with the history of poor pregnancy outcomes were in group I, while 206 patients with no obstetric pathology in previous pregnancies were in group II. L. monocytogenes antibodies to one or more serotypes were detected in 21.5% (59/275) of the patients, the rate being 20.3% in group I and 21.8% in group II. No statistically significant difference was detected between the two study groups (p > 0.05), indicating that this test was not an appropriate marker for the diagnosis of listeriosis during pregnancy. The total rate of positive results in cord sera was 0.7% (2/275) and the positive two sera were from samples in group II. The follow-up of the newborns, including the two cord blood positive ones, revealed no fetomaternal infection. The most frequently detected serotypes were 4ab (40%) and 1/2c (37%). Risk factors such as non-specific febrile illness during pregnancy (p < 0.001), consumption of ready-made food (p = 0.008), consumption of raw milk and milk products (p < 0.001) were found to be related to the presence of > or = 1/320 titers of L. monocytogenes antibodies. The major limiting factor in this study was the inability to obtain second serum samples from the mothers and newborns following delivery, to confirm the diagnosis by seroconversion. These results emphasize the need for the development of rapid, simple and reliable tests, alternative to culture methods, for the early and proper diagnosis of Listeria infections during pregnancy.
单核细胞增生李斯特菌可能导致宫内感染，若能及时诊断则可进行治疗。然而，目前尚无针对孕期李斯特菌病诊断的具有高特异性和高灵敏度的快速常规筛查试验。我们使用凝集试验检测了275对母婴血清中不同的单核细胞增生李斯特菌O抗体，以诊断李斯特菌病，并旨在评估不良妊娠结局、单核细胞增生李斯特菌O血清型抗体水平与李斯特菌病危险因素之间的相关性。2002年4月至8月期间，从安卡拉一家国立医院共收集了275名孕妇（年龄范围16 - 38岁）的母婴血样。采用试管凝集法，共对550份血清进行了针对血清型1/2c、3b、4ab、4c、4d的O抗原检测，滴度≥1/320被视为阳性。第一组为有不良妊娠结局史的69例患者，第二组为既往妊娠无产科病理情况的206例患者。21.5%（59/275）的患者检测到针对一种或多种血清型的单核细胞增生李斯特菌抗体，第一组的比例为20.3%，第二组为21.8%。两组之间未检测到统计学显著差异（p＞0.05），这表明该试验并非孕期李斯特菌病诊断的合适标志物。脐血血清阳性结果的总比例为0.7%（2/275），两份阳性血清均来自第二组的样本。对包括两份脐血阳性样本在内的新生儿进行随访，未发现母婴感染情况。最常检测到的血清型为4ab（40%）和1/2c（37%）。发现孕期非特异性发热疾病（p＜0.001）、食用即食食品（p = 0.008）、食用生牛奶和奶制品（p＜0.001）等危险因素与单核细胞增生李斯特菌抗体滴度≥1/320的存在有关。本研究的主要限制因素是产后无法从母亲和新生儿处获取第二份血清样本，以通过血清转化来确诊。这些结果强调了需要开发快速、简单且可靠的检测方法，以替代培养方法，用于孕期李斯特菌感染的早期和准确诊断。
