title: Pregnancy-associated listeriosis: clinical characteristics and geospatial analysis of a 10-year period in Israel.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Our survey emphasizes the high rate of pregnancy-related listeriosis in Israel and shows that specific clones might account for this.
authors: Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Ein Kerem.
authors: Hila
authors: H
authors: Elinav
authors: Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba.
authors: Anat
authors: A
authors: Hershko-Klement
authors: Ministry of Health Central Laboratories, Jerusalem.
authors: Lea
authors: L
authors: Valinsky
authors: Ministry of Health Central Laboratories, Jerusalem.
authors: Josef
authors: J
authors: Jaffe
authors: Koret School of Veterinary Medicine, Robert Smith Faculty of Agricultural, Food and Environmental Sciences, Hebrew University.
authors: Anat
authors: A
authors: Wiseman
authors: Weizmann Institute of Science, Rehovot.
authors: Hila
authors: H
authors: Shimon
authors: Department of Medicine, Rambam Medical Center, Haifa.
authors: Eyal
authors: E
authors: Braun
authors: Microbiology Laboratory, Meir Medical Center, Kfar Saba, Israel.
authors: Yossi
authors: Y
authors: Paitan
authors: Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Ein Kerem.
authors: Colin
authors: C
authors: Block
authors: Weizmann Institute of Science, Rehovot.
authors: Rotem
authors: R
authors: Sorek
authors: Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Ein Kerem.
authors: Ran
authors: R
authors: Nir-Paz
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007557:Israel / Q000453:epidemiology; D008089:Listeria monocytogenes; D008088:Listeriosis / Q000453:epidemiology* / Q000473:pathology* / Q000635:transmission; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000473:pathology*; D012189:Retrospective Studies; D062206:Spatial Analysis; D016019:Survival Analysis; D019371:Topography, Medical; D055815:Young Adult
keywords: Listeria monocytogenes; listeriosis; pregnancy-related infections