Listeria monocytogenes

One-Sentence Definition

Listeria monocytogenes is a Gram-positive rod that survives refrigeration and invades host cells, causing foodborne gastroenteritis and life-threatening meningitis/bacteremia in pregnant, elderly, and immunocompromised patients.

Taxonomy & Morphology

  • Gram-positive short rods; tumbling motility at room temperature
  • Facultative intracellular pathogen; grows at 4 °C (cold enrichment)
  • Catalase-positive; β-hemolytic (narrow)

Virulence Highlights

  • Internalins (InlA/InlB) — epithelial/placental invasion
  • Listeriolysin O (LLO) — escape from phagosome
  • ActA — actin-based intracellular motility (cell-to-cell spread)
  • Stress survival in food chain (biofilm on equipment)

Clinical Syndromes

  • Febrile gastroenteritis (outbreaks)
  • Bacteremia, meningoencephalitis (rhombencephalitis)
  • Pregnancy: amnionitis, stillbirth, neonatal sepsis (early/late)

Diagnosis

  • Blood/CSF culture; cold enrichment for food
  • MALDI / biochemicals; PCR panels increasingly include Listeria
  • Notify public health for invasive cases

Treatment Notes (conceptual)

  • Ampicillin ± gentamicin for synergy in invasive disease (classic regimen logic)
  • TMP-SMX alternative in penicillin allergy (confirm local practice)
  • Duration longer for meningitis/endocarditis

AMR

  • Generally susceptible to ampicillin historically; resistance uncommon but monitored
  • Intrinsic resistance patterns differ from other Gram-positives — know local antibiograms

Genomics & Computational Notes

Active Recall

  1. Why does cold storage fail as a control for Listeria?
  2. Which virulence protein mediates phagosomal escape?
  3. Which patient groups need highest suspicion for invasive listeriosis?