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Clin Infect Dis. 2014 Oct;59(7):953-61. doi: 10.1093/cid/ciu504. Epub 2014 Jun 27.

Pregnancy-associated listeriosis: clinical characteristics and geospatial analysis of a 10-year period in Israel.

Author information

Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Ein Kerem.
Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba.
Ministry of Health Central Laboratories, Jerusalem.
Koret School of Veterinary Medicine, Robert Smith Faculty of Agricultural, Food and Environmental Sciences, Hebrew University.
Weizmann Institute of Science, Rehovot.
Department of Medicine, Rambam Medical Center, Haifa.
Microbiology Laboratory, Meir Medical Center, Kfar Saba, Israel.



Listeria monocytogenes is a foodborne pathogen that causes life-threatening infections in elderly, immunocompromised, and pregnant women. In pregnancy it may cause fetal loss or a preterm delivery, and the neonate is prone to neonatal sepsis and death.


We created a cohort of all L. monocytogenes cases during 10 years (1998-2007) in Israel, by a comprehensive review of cases in hospitals throughout the country and cases reported to the Ministry of Health.


One hundred sixty-six pregnancy-related listeriosis cases were identified, resulting in a yearly incidence of 5-25 cases per 100 000 births. Presentation associated with fetal demise was more common in the second trimester (55.3%), and preterm labor (52.3%) and abnormal fetal heart rate monitoring (22.2%) were more common in the third trimester (P = .001). Fetal viability was low in the second trimester (29.2%) and much higher (95.3%) in the third trimester. Each additional week of pregnancy increased the survival chance by 33% (odds ratio, 1.331 [95% confidence interval, 1.189-1.489]). A single case of maternal mortality was identified. Listeria monocytogenes serotype 4b was more common in pregnancy-related than in non-pregnancy-related cases (79.5% vs 61.3%, P = .011). Pulsed-field gel electrophoresis analysis suggested that 1 pulsotype is responsible for 35.7% of the pregnancy cases between 2001 and 2007. This clone is closely related to the Italian gastroenteritis-associated HPB2262 and the invasive US Scott A L. monocytogenes strains.


Our survey emphasizes the high rate of pregnancy-related listeriosis in Israel and shows that specific clones might account for this.


Listeria monocytogenes; listeriosis; pregnancy-related infections

[Indexed for MEDLINE]

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