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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Listeria monocytogenes, a small gram-positive bacillus, causes sepsis and meningitis in immunocompromised patients and a devastating maternal/fetal infection in pregnant women. Recent outbreaks demonstrated that L. monocytogenes can cause gastroenteritis in otherwise healthy individuals and more severe invasive disease in immunocompromised patients. Centralized processing in the food industry may be the cause of these large-scale listeriosis outbreaks. The mouse model of listeriosis, which was developed in the 1960s, has been extraordinarily useful for studying T cell-mediated immunity. Contrary to the original concept that macrophages are the principal effector cells in listeriosis, we found that immigrating neutrophils play the predominant role in early liver defenses. At later time points, CD8(+) T cells lyse infected hepatocytes by both perforin- and Fas-L/Fas--dependent mechanisms. Of interest, nonclassical major histocompatibility complex (MHC) class Ib--restricted cytolytic activity is expressed early during primary infection, whereas MHC class Ia--restricted activity is predominant through late primary and secondary infections.
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PMID:Listeria monocytogenes: clinical and experimental update. 1186 36

A fourty-year-old woman suffered from meningitis and sepsis of Listeria monocytogenes, after presenting with several early symptoms from systemic lupus erythematosus (SLE). Listeriosis often causes central nervous system infection with relatively high mortality rate. This infection commonly affects patients with predisposing factor, such as immunosuppression. According to the previous reports, all of the previous reports, all of listeriosis with SLE received immunosuppressive therapy. To the best of our knowledge, no case of listeriosis has ever been reported in SLE patients without medication to SLE, although most of the previously reported cases of listeriosis with collagen disease accompanied SLE. We presume that suppression of T cell-mediated immunity, which is characteristic of SLE, plays a role as a predisposing factor in listerial infection.
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PMID:[A case of untreated systemic lupus erythematosus presenting with listerial meningitis]. 1196 42

Listeria monocytogenes is an uncommon cause of illness in the general population. However, this bacterium is an important cause of severe infections in neonates, pregnant women, the elderly, transplant recipients and other patients with impaired cell-mediated immunity. Various clinical syndromes due to L. monocytogenes have been described such as sepsis, central nervous system infections, endocarditis, gastroenteritis and localized infections. A review of the clinical presentation of listeriosis is given in this paper.
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PMID:Listeriosis: clinical presentation. 1264 33

Listeria monocytogenes has been recognized as a human pathogen for more than 70 years. It causes illness mainly in pregnant women, newborns, elderly, and immunocompromised persons. Although L. Monocytogenes is a relatively uncommon pathogen in neonates, it can cause considerable morbidity and mortality in this age group, especially in the early-onset form of the disease. In Taiwan, neonatal listeriosis is rarely reported. We report one case of a premature newborn with early-onset listeria sepsis and meningitis.
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PMID:Early-onset listeriosis in prematurity. 1284 54

The clinical and laboratory findings in 21 patients with listeriosis are described and the subject is reviewed. Eleven of the infections were septicemias of newborns, eight were meningitis in infants or adults, and two other children had unusual manifestations.Neonatal septicemia was rapidly fatal; one of 11 infants survived. The disease often seemed traceable to mild maternal infection during the third trimester usually leading to premature delivery of critically ill babies. Only awareness of the possible presence of listeriosis and early antibiotic therapy seem capable of reducing this high mortality.Tissues from autopsies showed characteristic microscopic necrotic foci with mononuclear infiltration progressing to microabscesses containing small Gram-positive rods. Lesions were found in the one placenta examined.Five infants with meningitis recovered, and one of three affected adults. Specific diagnosis depends on demonstrating Listeria monocytogenes; differentiation from other forms of acute meningitis cannot be made clinically.One older child had septicemia and another had listerial pharyngitis. Both recovered.
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PMID:Listeria monocytogenes infections in Metropolitan Toronto. A clinicopathological study. 1398 99

Listeria monocytogenes is a food-borne pathogen that can cause a variety of illnesses ranging from gastroenteritis to life-threatening septicemia. The beta-lactam antibiotic ampicillin remains the drug of choice for the treatment of listeriosis. We have previously identified a response regulator of a putative two-component signal transduction system that plays a role in the virulence and ethanol tolerance of L. monocytogenes. Here we present evidence that the response regulator, CesR, and a histidine protein kinase, CesK, which is encoded by the gene downstream from cesR, are involved in the ability of L. monocytogenes to tolerate ethanol and cell wall-acting antibiotics of the beta-lactam family. Furthermore, CesRK controls the expression of a putative extracellular peptide encoded by the orf2420 gene, located immediately downstream from cesRK. Inactivation of orf2420 revealed that it contributes to ethanol tolerance and pathogenesis in mice. Interestingly, we found that transcription of orf2420 was strongly induced by subinhibitory concentrations of various cell wall-acting antibiotics, ethanol, and lysozyme. The induction of orf2420 expression was abolished in the absence of CesRK. Our data suggest that CesRK is involved in regulating aspects of the cell envelope architecture and that changes in cell wall integrity provide a potent stimulus for CesRK-mediated regulation. These results further our understanding of how L. monocytogenes senses and responds to antibiotics that are used therapeutically in the treatment of infectious diseases.
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PMID:CesRK, a two-component signal transduction system in Listeria monocytogenes, responds to the presence of cell wall-acting antibiotics and affects beta-lactam resistance. 1457 97

Listeria monocytogenes is a food-borne bacterial pathogen that causes a wide spectrum of diseases, such as meningitis, septicemia, abortion, and gastroenteritis, in humans and animals. Among the 13 L. monocytogenes serovars described, invasive disease is mostly associated with serovar 4b strains. To investigate the genetic diversity of L. monocytogenes strains with different virulence potentials, we partially sequenced an epidemic serovar 4b strain and compared it with the complete sequence of the nonepidemic L. monocytogenes EGDe serovar 1/2a strain. We identified an unexpected genetic divergence between the two strains, as about 8% of the sequences were serovar 4b specific. These sequences included seven genes coding for surface proteins, two of which belong to the internalin family, and three genes coding for transcriptional regulators, all of which might be important in different steps of the infectious process. Based on the sequence information, we then characterized the gene content of 113 Listeria strains by using a newly designed Listeria array containing the "flexible" part of the sequenced Listeria genomes. Hybridization results showed that all of the previously identified virulence factors of L. monocytogenes were present in the 93 L. monocytogenes strains tested. However, distinct patterns of the presence or absence of other genes were identified among the different L. monocytogenes serovars and Listeria species. These results allow new insights into the evolution of L. monocytogenes, suggesting that early divergence of the ancestral L. monocytogenes serovar 1/2c strains from the serovar 1/2b strains led to two major phylogenetic lineages, one of them including the serogroup 4 strains, which branched off the serovar 1/2b ancestral lineage, leading (mostly by gene loss) to the species Listeria innocua. The identification of 30 L. monocytogenes-specific and several serovar-specific marker genes, such as three L. monocytogenes serovar 4b-specific surface protein-coding genes, should prove powerful for the rapid tracing of listeriosis outbreaks, but it also represents a fundamental basis for the functional study of virulence differences between L. monocytogenes strains.
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PMID:New aspects regarding evolution and virulence of Listeria monocytogenes revealed by comparative genomics and DNA arrays. 1474 55

Early diagnosis of cranial sepsis is mandatory if morbidity is to be avoided. In the case of structural integrity of the skull, haematogenous spread or extension from adjacent structures, especially the sinuses, are the most common sources of infection. Infections may be limited to compartments by the meninges or spread diffusely. Focal disease includes brain abscess as well as subdural and extradural empyaema. A history or signs of sinus disease should always be sought. Tuberculosis, lyme disease and listeriosis may present specific pathological findings. A series of cases is presented to illustrate the role of imaging in infective disease and to draw attention to diagnostic and management points of which radiologists should be aware.
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PMID:Cranial bacterial infection. 1474 53

Listeriosis is an emerging opportunistic infection in the immunocompromised host. A case of sepsis due to Listeria monocytogenes in a patient with advanced HIV infection and severe neutropenia, treated for an underlying non-Hodgkin's lymphoma, is described. Therapy with cotrimoxazole associated with rHuG-CSF (filgrastim) led to a rapidly favourable clinical and microbiological outcome, and to the correction of concurrent neutropenia. The case report is discussed according to a literature review of all cases of listeriosis reported until now in the setting of HIV infection and AIDS. In particular, the role of both cotrimoxazole and rHuG-CSF adjunct in the treatment of listeriosis in the immunocompromised patient is focused.
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PMID:[A case report of Listeria monocytogenes infection in a patient with AIDS. Efficacy of treatment with cotrimoxazole associated with rHuG-CSF (filgrastim)]. 1496 99

It is still not quite well understood why there is no optimal or even a satisfactory antibiotic therapy for listeriosis. Although almost all Listeria strains that induce sepsis, meningitis and encephalitis, as well as many other manifestations--in particular, in immunocompromised individuals--are susceptible to most of the common antibiotics, the cure rate is only approximately 70%. The most effective regimen still consists of a combination of an aminopenicillin (amoxicillin or ampicillin) plus an aminoglycoside. In vitro, this combination is bactericidal, whereas aminopenicillin alone only exerts a weak bactericidal activity against Listeriae. These antibiotics only poorly penetrate the cerebrospinal fluid and thus, only high doses given over a prolonged period of 2-3 weeks are curative. Furthermore, Listeria monocytogenes belongs to the group of facultative intracellular bacteria, which means that a certain population is inaccessible for antibiotics. Theoretically, a drug which is endowed with bactericidal activity superior to that of ampicillin would be preferable. Furthermore, the candidate drug should easily cross the blood-brain barrier into the CNS, be able to accumulate within host cells, reach the cytoplasm and be active under these unusual conditions. Because of all these arguments, the new quinolones are of particular interest; but broad clinical data are still lacking. It is unclear as to whether antibiotics alone will be sufficient to increase the prognosis. Adjunctive therapy with immunomodulators, which are able to reconstitute the defective defence capacities, would presumably create the conditions necessary to finally resolve listeriosis.
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PMID:An update on the medical management of listeriosis. 1526 87


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