An Outbreak of Type 4b Listeria monocytogenes Infection Involving Patients From Eight Boston Hospitals

Ho, John L.; Shands, Kathryn N.; Friedland, Gerald; Eckind, Paul; Fraser, David W.

doi:10.1001/archinte.1986.00360150134016

Cited by 281 publications

(83 citation statements)

References 20 publications

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“…There is no known association between PPI use and increased risk of Listeria infection, although human listeriosis has been associated with antacid and H2 blocker use in a retrospective case-control study of inpatients using these agents during an outbreak of hospital-acquired listeriosis [106].…”

Section: Shigella and Listeriamentioning

confidence: 99%

Adverse Effects of Long-Term Proton Pump Inhibitor Therapy

2011

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Proton pump inhibitors have an excellent safety profile and have become one of the most commonly prescribed class of drugs in primary and specialty care. Long-term, sometimes lifetime, use is becoming increasingly common, often without appropriate indications. This paper is a detailed review of the current evidence on this important topic, focusing on the potential adverse effects of long-term proton pump inhibitor use that have generated the greatest concern: B12 deficiency; iron deficiency; hypomagnesemia; increased susceptibility to pneumonia, enteric infections, and fractures; hypergastrinemia and cancer; drug interactions; and birth defects. We explain the pathophysiological mechanisms that may underlie each of these relationships, review the existing evidence, and discuss implications for clinical management. The benefits of proton pump inhibitor use outweigh its risks in most patients. Elderly, malnourished, immune-compromised, chronically ill, and osteoporotic patients theoretically could be at increased risk from long-term therapy.

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Section: Shigella and Listeriamentioning

confidence: 99%

Adverse Effects of Long-Term Proton Pump Inhibitor Therapy

2011

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“…Pregnant women account for one third of cases, and their risk for infection is 17 times higher than that of the general population [18]. In two foodborne outbreaks, 50% to 87% of affected adults who were not pregnant had an underlying medical condition [19,20]. A study by the CDC involving sporadic cases of listeriosis showed that 69% of cases in nonpregnant individuals involved patients with an underlying medical condition [21].…”

Section: Microbiologymentioning

confidence: 99%

“…The use of histamine-2 antagonists or antacids to alkalinize the stomach has been shown to increase the risk of infection [20,21]; however, not all investigations support this association [18]. A single report suggested an association between laxative use and listeriosis with an odds ratio of 1.92 [21].…”

Section: Pathogenesismentioning

confidence: 99%

Update on listeria monocytogenes infection

Crum

2002

Curr Gastroenterol Rep

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Listeria monocytogenes is a gram-positive bacillus that causes meningitis, encephalitis, bacteremia, and febrile gastroenteritis. Most disease occurs in immunosuppressed individuals. Recent seroepidemiologic studies show that the infection is foodborne. Due to the increasing number of immunosuppressed individuals at risk for listeriosis, as well as the persistence of substantial foodborne outbreaks, L. monocytogenes has gained worldwide attention as an important pathogen. Heightened surveillance and quality control by the food industry have been instituted, leading to a reduction in the number of cases and deaths from this infection in the past decade. However, due to the ubiquity of the organism in the environment, outbreaks and sporadic disease continue to occur. The standard therapy for listeriosis is a combination of ampicillin and gentamicin or, for patients who are intolerant of b-lactam agents, trimethoprim-sulfamethazole. Despite the availability of therapy, the mortality rate remains high in those with T-cell immunodeficiencies.

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“…Genome sequencing of L. monocytogenes strain Scott A, a clinical isolate from a 1979 listeriosis outbreak in Boston in which contaminated vegetables were epidemiologically implicated (18), identified a putative new member of the CadA family (tentatively termed CadA4) within a large (ϳ35kb) genomic island in the chromosome of this strain (19). The gene cadA4 was also detected in another strain from this outbreak (20) and in additional strains (14), including in 29% of serotype 4b isolates from sporadic human listeriosis cases in the United States from 2005 to 2008 (8).…”

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confidence: 99%

Novel Cadmium Resistance Determinant in Listeria monocytogenes

Parsons

Lee

Jayeola

et al. 2017

Appl Environ Microbiol

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Listeria monocytogenes is a foodborne pathogen that can cause severe disease (listeriosis) in susceptible individuals. It is ubiquitous in the environment and often exhibits resistance to heavy metals. One of the determinants that enables Listeria to tolerate exposure to cadmium is the cadAC efflux system, with CadA being a P-type ATPase. Three different cadA genes (designated cadA1 to cadA3) were previously characterized in L. monocytogenes. A novel putative cadmium resistance gene (cadA4) was recently identified through whole-genome sequencing, but experimental confirmation for its involvement in cadmium resistance is lacking. In this study, we characterized cadA4 in L. monocytogenes strain F8027, a cadmium-resistant strain of serotype 4b. By screening a mariner-based transposon library of this strain, we identified a mutant with reduced tolerance to cadmium and that harbored a single transposon insertion in cadA4. The tolerance to cadmium was restored by genetic complementation with the cadmium resistance cassette (cadA4C), and enhanced cadmium tolerance was conferred to two unrelated cadmium-sensitive strains via heterologous complementation with cadA4C. Cadmium exposure induced cadA4 expression, even at noninhibitory levels. Virulence assessments in the Galleria mellonella model suggested that a functional cadA4 suppressed virulence, potentially promoting commensal colonization of the insect larvae. Biofilm assays suggested that cadA4 inactivation reduced biofilm formation. These data not only confirm cadA4 as a novel cadmium resistance determinant in L. monocytogenes but also provide evidence for roles in virulence and biofilm formation.IMPORTANCE Listeria monocytogenes is an intracellular foodborne pathogen causing the disease listeriosis, which is responsible for numerous hospitalizations and deaths every year. Among the adaptations that enable the survival of Listeria in the environment are the abilities to persist in biofilms, grow in the cold, and tolerate toxic compounds, such as heavy metals. Here, we characterized a novel determinant that was recently identified on a larger mobile genetic island through whole-genome sequencing. This gene (cadA4) was found to be responsible for cadmium detoxification and to be a divergent member of the Cad family of cadmium efflux pumps. Virulence assessments in a Galleria mellonella model suggested that cadA4 may suppress virulence. Additionally, cadA4 may be involved in the ability of Listeria to form biofilms. Beyond the role in cadmium detoxification, the involvement of cadA4 in other cellular functions potentially explains its retention and wide distribution in L. monocytogenes.KEYWORDS Listeria monocytogenes, cadmium resistance, cadA, biofilm, virulence L isteria monocytogenes is a Gram-positive rod-shaped bacterium widely distributed in nature (1). As a facultative intracellular foodborne pathogen causing the disease listeriosis, L. monocytogenes organisms are responsible for numerous hospitalizations and deaths in the United States every year (2). T...

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An Outbreak of Type 4b Listeria monocytogenes Infection Involving Patients From Eight Boston Hospitals

Cited by 281 publications

References 20 publications

Adverse Effects of Long-Term Proton Pump Inhibitor Therapy

Adverse Effects of Long-Term Proton Pump Inhibitor Therapy

Update on listeria monocytogenes infection

Novel Cadmium Resistance Determinant in Listeria monocytogenes

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