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Listeriosis is a disease make by the bacteria Listeria monocytogenes . The septic person can continue as an asymptomatic attack aircraft carrier if possesses a adequate to resistant system to fight against the bacterium , but in other shell , the listeriosis affected role will present some symptoms that could be animation threatening if not treated properly on time .
It is a micro-organism of universal distribution , relatively resistant to refrigeration , dryness and extreme heat . The principal reservoirs are territory , forage , water , silos and the GI tract of birds , Pisces , and mammals including Isle of Man . Infection is usually acquired through the ingestion of contaminated food , although the reference can not always be key out .
The absolute majority of listeria meningitis cases are link with the consumption of unpasteurized bleak meat , Pisces the Fishes and veggie and dairy products ; also , have described buds with different preparations of high mallow , sausage , pates , ice creamand , in worldwide , refrigerated product , without cookery or heating requirements prior to consumption . Newborns usually acquire the transmission vertically , through the placenta or septic birth epithelial duct .
How Do You Treat Listeriosis?
The inadequate initial treatment of meningitis due to Listeria is associated in some study with an increase in death rate , so the empirical guidepost in immunosuppressed patients and in adults sometime than 60 years should include coverage against this microorganism . According to other studies , the evolution has been main of the used discussion , so it seems that the prognosis is more related to the listeriosis affected role ’s situation .
Most antibiotic , including penicillin , work against L. monocytogenes . The aminoglycosides , glycopeptides , and cotrimoxazole are bactericidal .
Cephalosporins are not active and are a priority to be taken into account in the cirrhosis of the liver with peritoneal inflammation and in the empirical intervention of meningitis .
This intracellular pathogen has a enceinte power to elude host defense mechanisms and reach persistence .
As a worldwide pattern for plow listeria meningitis , high Lucy in the sky with diamonds will be used for a keep up time , always have to identify the guidepost depending on the type of affected role and the evolution .
The recommended choice for in organization contagion of the central nervous system is tie in SK-Ampicillin , at least -and if nephritic role let it- the first 10 mean solar day , to gentamicin , since despite its poor concentration in cerebrospinal fluid the combination is synergetic . Although this potentiation is only extracellular and there are currently unsolvable doubts about whether that synergism has clinical implication .
There is also synergy with Polycillin and cotrimoxazole ( this last one with greater blood - genius diffusion than Garamycin ) , with at least superimposable and likely greater efficacy as well as a low-down risk of exposure of nephrotoxicity ( it refers to renal toxicity ) . Another potential combination for listeriosis is cotrimoxazole plus rifampin , or isolated cotrimoxazole . These same guidelines are recommend in endocarditis and other severe conformation , and in infections in immunosuppressed patients or neonates .
In pregnant women , Polycillin is the best alternative for listeria meningitis . As an choice , cotrimoxazole may be used , except in the first trimester and in the last calendar month .
Levofloxacin , meropenem , and linezolid are also alive . Specifically , meropenem , although it is also bacteriostatic , has an excellent activity and could be used in monotherapy . The efficacy of vancomycin is irregular . Although some have advocated the consumption of clarithromycin and doxycycline in stranded bacteriaemia , they should never be used unless other listeria meningitis antibiotics can not be used because they are bacteriostatic , their intrinsical activity is poor and resistance has been described .
Some listeriosis antibiotics that lack in vitro activity could be effective in vivo , as seems to be the case with fosfomycin . There are no clinical test in this attentiveness , and it is difficult that can be set in motion , among other causal agency , by the low incidence of the disease .
Resistance does not seem to be a problem in the intervention of listeriosis , although there are strains resistant to cotrimoxazole , tetracyclines , carbapenems , and Garamycin .
Conclusion
The proper handling of listeria meningitis implies the use of antibiotic drug , which can be used in monotherapy or combined to get better outcome . The difficulties of intervention do not infer from mechanisms of acquired ohmic resistance but from the characteristics of the bacterium ( pertinacity and tolerance ) and the patients ( immunosuppressed or damp ) .
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