Wang Zhaoyun, Tao Xiaojing, Liu Shan, Zhao Yutong, Yang Xiuhua
Department of Clinical Medicine, China Medical University, Shenyang, Liaoning, People's Republic of China.
Department of Obstetrics, The First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Infect Drug Resist. 2021 May 26;14:1967-1978. doi: 10.2147/IDR.S313675. eCollection 2021.
Listeria monocytogenes (LM) is an intracellular, aerobic and facultative anaerobic, Gram-positive bacterium, which is primarily transmitted to humans orally via food. LM could occur in asymptomatic pregnant women; however, fetal infection is a serious condition, entailing premature birth, abortion, sepsis, central nervous system (CNS) involvement, or even death. If a pregnant woman exhibits symptoms, the performance is almost like influenza, such as fever, headache, diarrhea, myalgia, or other digestive-related symptoms. This review collected clinical and empirical results regarding the mechanism, clinical manifestations, obstetrical outcome, diagnosis, treatment, vertical transmission, neonatal infection, and prevention of listeriosi according to articles published in PubMed from January 1, 1980, to March 20, 2021. The early detection and diagnosis of pregnancy-associated listeriosis are significant since sensitive antibiotics are effective at enhancing the prognosis of newborns. Listeriosis can be diagnosed using positive cultures from maternal or neonatal blood, neonatal cerebrospinal fluid (CSF), amniotic fluid, intrauterine mucosa, or the placenta. Two weeks of high-dose intravenous amoxicillin (more than 6 g/day) is recommended for LM pregnant women without allergy. Terminating the pregnancy to save the mother's life should be considered if maternal and fetal conditions aggravate. Neonatal Listeria infection is primarily transmitted through the placenta, which is a critical illness associated with a high mortality rate. The necessary dietary guidance for pregnant women can reduce the incidence rate of pregnancy-related listeriosis.
单核细胞增生李斯特菌（LM）是一种细胞内寄生、需氧兼性厌氧的革兰氏阳性菌，主要通过食物经口传播给人类。LM可发生于无症状的孕妇；然而，胎儿感染是一种严重情况，可导致早产、流产、败血症、中枢神经系统（CNS）受累，甚至死亡。如果孕妇出现症状，表现几乎类似于流感，如发热、头痛、腹泻、肌痛或其他消化系统相关症状。本综述根据1980年1月1日至2021年3月20日发表在PubMed上的文章，收集了有关李斯特菌病的机制、临床表现、产科结局、诊断、治疗、垂直传播、新生儿感染及预防的临床和实证结果。妊娠相关李斯特菌病的早期检测和诊断具有重要意义，因为敏感抗生素可有效改善新生儿预后。李斯特菌病可通过母体或新生儿血液、新生儿脑脊液（CSF）、羊水、子宫内黏膜或胎盘的阳性培养物进行诊断。对于无过敏的LM感染孕妇，建议静脉注射两周高剂量阿莫西林（超过6克/天）。如果母婴情况恶化，应考虑终止妊娠以挽救母亲生命。新生儿李斯特菌感染主要通过胎盘传播，这是一种与高死亡率相关的重症疾病。对孕妇进行必要的饮食指导可降低妊娠相关李斯特菌病的发病率。
