Listeria

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Listeria
Scanning electron micrograph of Listeria monocytogenes.
Scientific classification
Kingdom: Bacteria
Division: Firmicutes
Class: Bacilli
Order: Bacillales
Family: Listeriaceae
Genus: Listeria
Pirie 1940
Species

L. fleischmannii
L. grayi
L. innocua
L. ivanovii
L. marthii
L. monocytogenes
L. rocourtiae
L. seeligeri
L. weihenstephanensis
L. welshimeri

Listeria is a genus of bacteria that contains ten species. Named after the English pioneer of sterile surgery Joseph Lister, the genus received its current name in 1940. Listeria species are facultatively anaerobic, Gram-positive bacilli.1 The major human pathogen in the Listeria genus is L. monocytogenes. It is usually the causative agent of the relatively rare bacterial disease, listeriosis, a serious infection caused by eating food contaminated with the bacteria. The disease affects primarily pregnant women, newborns, adults with weakened immune systems, and the elderly.

Listeriosis is a serious disease for humans; the overt form of the disease has a mortality rate of about 20 percent. The two main clinical manifestations are sepsis and meningitis. Meningitis is often complicated by encephalitis, a pathology that is unusual for bacterial infections. Listeria ivanovii is a pathogen of mammals, specifically ruminants, and has rarely caused listeriosis in humans.2

Background

The first documented case of Listeria was in 1924. In the late 1920s, two researchers independently identified Listeria monocytogenes from animal outbreaks. They proposed the genus Listerella in honor of surgeon and early antiseptic advocate Joseph Lister; however, that name was already in use for a slime mold and a protozoan. Eventually, the genus Listeria was proposed and accepted. All species within the Listeria genus are Gram-positive, nonsporeforming, catalase-positive rods. The genus Listeria was classified in the family Corynebacteriaceae through the seventh edition of Bergey's Manual of Systematic Bacteriology. The 16S rRNA cataloging studies of Stackebrandt, et al. demonstrated that L. monocytogenes is a distinct taxon within the Lactobacillus-Bacillus branch of the bacterial phylogeny constructed by Woese. In 2004, the genus was placed in the newly created Family Listeriaceae. The only other genus in the family is Brochothrix.3

The genus Listeria currently contains ten species: L. fleischmannii, L. grayi, L. innocua, L. ivanovii, L. marthii, L. monocytogenes, L. rocourtiae, L. seeligeri, L. weihenstephanensis and L. welshimeri. Listeria dinitrificans, previously thought to be part of the Listeria genus, was reclassified into the new genus Jonesia.4 Under the microscope, Listeria species appear as small, Gram-positive rods, which are sometimes arranged in short chains. In direct smears, they may be coccoid, so they can be mistaken for streptococci. Longer cells may resemble corynebacteria. Flagella are produced at room temperature, but not at 37 °C. Hemolytic activity on blood agar has been used as a marker to distinguish L. monocytogenes among other Listeria species, but it is not an absolutely definitive criterion. Further biochemical characterization may be necessary to distinguish between the different species of Listeria.

Listeria can be found in soil, which can lead to vegetable contamination. Animals can also be carriers. Listeria has been found in uncooked meats, uncooked vegetables, fruit such as cantaloupes,5 pasteurized or unpasteurized milk, foods made from milk, and processed foods. Pasteurization and sufficient cooking kill Listeria; however, contamination may occur after cooking and before packaging. For example, meat-processing plants producing ready-to-eat foods, such as hot dogs and deli meats, must follow extensive sanitation policies and procedures to prevent Listeria contamination.6 Listeria monocytogenes is commonly found in soil, stream water, sewage, plants, and food.7 Listeria is responsible for listeriosis, a rare but potentially lethal food-borne infection. The case fatality rate for those with a severe form of infection may approach 25%.8 (Salmonella, in comparison, has a mortality rate estimated at less than 1%.9) Although Listeria monocytogenes has low infectivity, it is hardy and can grow in temperatures from 4 °C (39.2 °F) (the temperature of a refrigerator), to 37 °C (98.6 °F), (the body's internal temperature).7 Listeriosis is a serious illness, and the disease may manifest as meningitis, or affect newborns due to its ability to penetrate the endothelial layer of the placenta.8

Pathogenesis

Listeria uses the cellular machinery to move around inside the host cell: It induces directed polymerization of actin by the ActA transmembrane protein, thus pushing the bacterial cell around.10

Listeria monocytogenes, for example, encodes virulence genes that are thermoregulated. The expression of virulence factor is optimal at 39°C, and is controlled by a transcriptional activator, PrfA, whose expression is thermoregulated by the PrfA thermoregulator UTR element. At low temperatures, the PrfA transcript is not translated due to structural elements near the ribosome binding site. As the bacteria infect the host, the temperature of the host melts the structure and allows translation initiation for the virulent genes.

The majority of Listeria bacteria are targeted by the immune system before they are able to cause infection. Those that escape the immune system's initial response, however, spread through intracellular mechanisms and are, therefore, guarded against circulating immune factors (AMI).8

To invade, Listeria induces macrophage phagocytic uptake by displaying D-galactose in their teichoic acids that are then bound by the macrophage's polysaccharide receptors. Other important adhesins are the internalins.9 Once phagocytosed, the bacterium is encapsulated by the host cell's acidic phagolysosome organelle.7 Listeria, however, escapes the phagolysosome by lysing the vacuole's entire membrane with secreted hemolysin,11 now characterized as the exotoxin listeriolysin O.7 The bacteria then replicate inside the host cell's cytoplasm.8

Listeria must then navigate to the cell's periphery to spread the infection to other cells. Outside the body, Listeria has flagellar-driven motility, sometimes described as a "tumbling motility". However, at 37 °C, flagella cease to develop and the bacterium instead usurps the host cell's cytoskeleton to move.8 Listeria, inventively, polymerizes an actin tail or "comet",11 from actin monomers in the host's cytoplasm 6 with the promotion of virulence factor ActA.8 The comet forms in a polar manner 12 and aids the bacteria's migration to the host cell's outer membrane. Gelsolin, an actin filament severing protein, localizes at the tail of Listeria and accelerates the bacterium's motility.12 Once at the cell surface, the actin-propelled Listeria pushes against the cell's membrane to form protrusions called filopods7 or "rockets". The protrusions are guided by the cell's leading edge 13 to contact adjacent cells, which then engulf the listeria rocket and the process is repeated, perpetuating the infection.8 Once phagocytosed, the bacterium is never again extracellular: it is an intracytoplasmic parasite 11 like Shigella flexneri and Rickettsia.8

Epidemiology

The Center for Science in the Public Interest has published a list of foods that have sometimes caused outbreaks of Listeria: hot dogs, deli meats, pasteurized or unpasteurized milk, cheeses (particularly soft-ripened cheeses like feta, Brie, Camembert, blue-veined, or Mexican-style queso blanco), raw and cooked poultry, raw meats, ice cream, raw vegetables, and raw and smoked fish.14 Cantaloupe has been implicated in an outbreak of listeriosis from a farm in Colorado,15 and the Australian company GMI Food Wholesalers were fined A$236,000 for providing Listeria monocytogenes-contaminated chicken wraps to the airline Virgin Blue.16

Prevention

Preventing listeriosis as a food illness requires effective sanitation of food contact surfaces. Alcohol is an effective topical sanitizer against Listeria. Quaternary ammonium can be used in conjunction with alcohol as a food contact safe sanitizer with increased duration of the sanitizing action. Refrigerated foods in the home should be kept below 4 °C (39.2 °F) to discourage bacterial growth. Preventing listeriosis also can be done by carrying out an effective sanitation of food contact surfaces.17

Treatment

In non-invasive listeriosis, the bacteria will often remain within the digestive tract, causing mild symptoms lasting only a few days and requiring only supportive care. Muscle pain and fever in mild cases can be treated with over-the-counter pain relievers, and diarrhea and gastroenteritis can be treated with over-the-counter medications if needed.18

In invasive listeriosis, the bacteria has spread to the bloodstream and central nervous system. Treatment includes intravenous delivery of high-dose antimicrobials and in-patient hospital care.18 Duration of hospital care will vary depending on how widespread the infection is, but is usually no less than 2 weeks.18 Ampicillin, penicillin, or amoxicillin are often given for invasive listeriosis, and gentamicin is often added in patients with compromised immune systems.19 Trimethoprim-sulfamethoxazole, vancomycin, and fluoroquinolones can be used in cases of allergy to penicillin.19 For treatment to be effective, the antibiotic must penetrate the host cell and bind to penicillin-binding protein 3 (PBP3). Cephalosporins are not effective for treatment of listeriosis.19

Prompt treatment of listeria infections in pregnancy is critical to prevent the bacteria from infecting the fetus, and antibiotics may be given to pregnant women even in non-invasive listeriosis.20 These oral therapies in less severe cases can include amoxicillin or erythromycin.19 In addition to antibiotic therapy, it often recommended that infected pregnant women receive ultrasounds to monitor the health of the fetus. Higher doses of antibiotics are sometimes given to pregnant women to ensure penetration of the umbilical cord and placenta.21

Asymptomatic patients who have been exposed to listeria are not recommended for treatment. It is recommended that these patients be informed of the signs and symptoms of the disease and to return for medical care if symptoms present.18

Research

Listeria is an opportunistic pathogen: It is most prevalent in the elderly, pregnant mothers, and AIDS patients. With improved healthcare leading to a growing elderly population and extended life expectancies for AIDS patients, physicians are more likely to encounter this otherwise-rare infection (only 7 per 1,000,000 healthy people are infected with virulent Listeria each year).7 Better understanding the cell biology of Listeria infections, including relevant virulence factors, may lead to better treatments for listeriosis and other intracytoplasmic parasite infections. Researchers are now investigating the use of Listeria as a cancer vaccine, taking advantage of its "ability to induce potent innate and adaptive immunity."622

See also

Notes

  1. ^ Singleton P (1999). Bacteria in Biology, Biotechnology and Medicine (5th ed.). Wiley. pp. 444–454. ISBN 0-471-98880-4. 
  2. ^ Christelle Guillet, Olivier Join-Lambert, Alban Le Monnier, Alexandre Leclercq, Frédéric Mechaï, Marie-France Mamzer-Bruneel, Magdalena K. Bielecka, Mariela Scortti, Olivier Disson, Patrick Berche, José Vazquez-Boland, Olivier Lortholary, and Marc Lecuit. Human Listeriosis Caused by Listeria ivanovii. Emerg Infect Dis. 2010 January; 16(1): 136–138.
  3. ^ Elliot T. Ryser, Elmer H. Marth. Listeria, Listeriosis, and Food Safety. Second edition. Elmer Marth. 1999.
  4. ^ M. D. Collins, S. Wallbanks, D. J. Lane, J. Shah, R. Nietupskin, J. Smida, M. Dorsch and E. Stackebrandt. Phylogenetic Analysis of the Genus Listeria Based on Reverse Transcriptase Sequencing of 16S rRNA. International Journal of Systematic and Evolutionary Microbiology. April 1991 vol. 41 no. 2 240-246
  5. ^ "Listeria outbreak expected to cause more deaths across US in coming weeks". The Guardian (London). 29 September 2011. 
  6. ^ a b c "Controlling Listeria Contamination in Your Meat Processing Plant". Government of Ontario. 27 February 2007. Retrieved 27 April 2010. 
  7. ^ a b c d e f Southwick, F.S.; D.L Purich. "More About Listeria". University of Florida Medical School. Retrieved 7 March 2007. 
  8. ^ a b c d e f g h "Todar's Online Textbook of Bacteriology". Listeria monocytogenes and Listeriosis. Kenneth Todar University of Wisconsin-Madison Department of Biology. 2003. Retrieved 7 March 2007. 
  9. ^ a b "Statistics about Salmonella food poisoning". WrongDiagnosis.com. 27 February 2007. Retrieved 7 March 2007. 
  10. ^ Smith GA, Portnoy DA (July 1997). "Trends in Microbiology". How the Listeria monocytogenes ActA protein converts actin polymerization into a motile force (Cell Press) 5 (7, number 7): 272–276. doi:10.1016/S0966-842X(97)01048-2. PMID 9234509. 
  11. ^ a b c Tinley, L.G. et al. (1989). "Actin Filaments and the Growth, Movement, and Spread of the Intracellular Bacterial Parasite, Listeria monocytogenes". The Journal of Cell Biology 109 (4 Pt 1): 1597–1608. doi:10.1083/jcb.109.4.1597. PMC 2115783. PMID 2507553. 
  12. ^ a b Laine RO, Phaneuf KL, Cunningham CC, Kwiatkowski D, Azuma T, Southwick FS (1 August 1998). "Gelsolin, a protein that caps the barbed ends and severs actin filaments, enhances the actin-based motility of Listeria monocytogenes in host cells". Infect. Immun. 66 (8): 3775–82. PMC 108414. PMID 9673261. 
  13. ^ Galbraith CG, Yamada KM, Galbraith JA (February 2007). "Polymerizing actin fibers position integrins primed to probe for adhesion sites". Science 315 (5814): 992–5. doi:10.1126/science.1137904. PMID 17303755. 
  14. ^ Center for Science in the Public InterestNutrition Action Healthletter – Food Safety Guide – Meet the Bugs
  15. ^ William Neuman (September 27, 2011). "Deaths From Cantaloupe Listeria Rise". The New York Times. Retrieved 13 November 2011. 
  16. ^ Josephine Tovey (November 16, 2011). "$236,000 fine for foul flight chicken". The Sydney Morning Herald. Retrieved 13 November 2011. 
  17. ^ "Maple Leaf Foods assessing Listeria-killing chemical". ctv.ca (ctvglobemedia). 2008-10-12. Retrieved 15 October 2008. 
  18. ^ a b c d "CDC - Listeria - Home". 
  19. ^ a b c d Temple ME, Nahata MC (May 2000). "Treatment of listeriosis". Annals of Pharmacotherapy 34 (5): 656–61. doi:10.1345/aph.19315. PMID 10852095. 
  20. ^ "Listeria infection (listeriosis): Treatments and drugs - MayoClinic.com". 
  21. ^ Janakiraman V (2008). "Listeriosis in pregnancy: diagnosis, treatment, and prevention". Rev Obstet Gynecol 1 (4): 179–85. PMC 2621056. PMID 19173022. 
  22. ^ Greenemeier L (May 21, 2008). "Recruiting a Dangerous Foe to Fight Cancer and HIV". Scientific American. 

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