36. Listeriosis. Etiology. Epidemiology. Pathomorphology and pathogenesis

Listeriosis is a disease manifested by septicemia or meningitis more often in newborns or those with reduced immunological reactions. The human causative agent is Listeria monocytogenes.

Etiology. The causative agent of listeriosis is a small gram-positive rod that does not form spores. It has mobility at room temperature, but loses this ability at 37 °C. When growing on blood agar, it causes beta-hemolysis, but occasionally has the ability to alpha-hemolysis.

When grown on conventional nutrient media, Listeria is often mistaken for diphtheroid bacteria and described as non-pathogenic microorganisms. When stained by Gram material obtained from patients, listeria is often found in the form of cocci, and therefore they are treated as streptococci.

Epidemiology. The pathogen has been isolated from soil where it has lived for more than 295 days, springs, sewage, silage, dust and slaughterhouse waste. It was isolated from the contents of the intestines, the vagina, it was found in the contents of the cervix, nose, ears, blood and urine of apparently healthy individuals. Listeriosis belongs to a new class of infectious diseases - "sapronosis", a characteristic feature of which is that the source of pathogens is not animals, as in zoonoses, and not a person, as in anthroponoses, but the substrate of the external environment.

Infection can occur in the following ways:

1) contact;

2) food (when eating food);

3) aerogenic (in contaminated rooms);

4) transmissively (through insect bites);

5) vertical (transplacental);

6) sexual (during sexual intercourse);

7) intrapartum (during childbirth). Pathomorphology. The disease is accompanied by damage to many organs, including the liver, lungs, kidneys, adrenal glands and brain. There are abscesses that do not differ from those in other purulent infections. Formation of microabscesses and granulations is possible. Necrotic processes are detected in the kidneys and lungs, especially in the bronchioles and the walls of the alveoli.

Listeria causes purulent meningitis and can be the cause of purulent epididymitis, encephalitis, choroiditis, and gliosis.

Pathogenesis. The entrance gates of infection can be any mucous membranes and damaged skin. At the site of the primary introduction of Listeria, they cause an inflammatory reaction involving the lymphatic apparatus. From the place of primary localization, they quickly spread by lymphogenous, hematogenous or neurogenic way to the internal organs, causing vascular and degenerative changes in them. First of all, the pathogen and its endotoxin show their hepatoneurotropism. In the affected organs, the pathogen accumulates and characteristic morphological changes are formed according to the type of listerioma granulomas. The development of the pathological process depends on the site of penetration of the pathogen.

Author: Pavlova N.V.

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