Neonatal listeriosis

ABSTRACT

A total of one hundred and fifty newborns were studied 30 with a picture of septicemia. 30 preterm, 30 with hyper bilirubinemia, 40 with respiratory distress and twenty healthy full term newborns as a control group. The work included cord and neonatal blood cultures and subcultures on blood agar and Listeria selective medias, transillumination technique, biochemical reactions for differentiation of different organisms in addition to detection of Listeria immunoglobulins against [la] and [4b]. The 150 cord blood cultures revealed 127/150 [84.66 percent] were negative, 23/150 [15.33 percent] were infected with Staph [4 percent], Strep [5.33 percent], E.coli [4 percent] and Listeria 3/150 [2 percent]. The 150 neonatal blood cultures revealed 60/150 [40 percent] were negative, 90/150 [60 percent] were infected with Staph [20 percent], Strept [17.33 percent], E coli [12.66 percent], Listeria 7/150 [4.66 percent], Pseudomonas [4.66 percent] and Pneumococci [0.66 percent]. The 7 cases of neonatal listeriosis were distributed as follows 4/7 [57.1 percent] in septic group, 2/7 [28.6 percent] in Respiratory distress group, 1/7 [14.3 percent] in hyperbilirubinmic group. The most common clinical presentations were poor suckling [85.7 percent], Lethargy [85.7 percent], hypothermia [57.14 percent], vomiting [42.8 percent], cyanosis [42.8 percent] and granulomas of mucous membrane [28.5 percent]. The Listeria positive cases revealed a significant decrease in weight 3.11+1.73, [P<0.05] and midarm circumference 11.54+0.89 [P< 0.05] but no statistically significant change in length and head circumference when compared to the full term healthy newborns. Inspite of immediate initiation of specific antibiotics combination the mortality rate was 2/7 [28.57 percent]. Three cases [42.8 percent] with high antibody titer against Listeria [4b] were positive to Listeria in both cord and neonatal blood cultures, the other 4/7 [57.1 percent] with also high antibody titer, were positive only in neonatal blood culture. The perinatal Listeriosis can occur through the contaminated hands of the personnel or by contaminated equipment used in handling babies and their mothers