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Background <p><i>Listeria monocytogenes</i>, a foodborne pathogen of particular concern in perinatal medicine, can cause severe maternal-fetal infections with high neonatal mortality rates. This study provides detailed temporal documentation of disease progression and therapeutic interventions and elucidates the genomic profiles of these clinical isolates.</p> Method <p>A retrospective analysis was conducted on the clinical data of a pregnant woman and her neonate. Isolates obtained from maternal and neonatal specimens underwent whole genome sequencing (WGS), followed by multi-locus sequence typing (MLST), core genome phylogenetic analysis, virulence gene profiling, and antimicrobial susceptibility testing.</p> Results <p>This case manifested as maternal febrile placentitis progressing to neonatal congenital infection and respiratory distress syndrome. Targeted antimicrobial therapy (maternal ampicillin; neonatal meropenem/amoxicillin-clavulanate) achieved full clinical resolution. Genomic investigations identified concurrent infection with two sequence type strains: (a) ST37/CC37 (mother-neonate pair) clustering with European clinical isolates; (b) ST378/CC19 (maternal bloodstream) showing genetic proximity to a clinical strain from Beijing. While all strains exhibited congruent susceptibility profiles (ampicillin, meropenem, penicillin, trimethoprim-sulfamethoxazole, erythromycin) and lacked acquired resistance genes, ST378 uniquely harbored the <i>inlP4</i> virulence gene absent in ST37.</p> Conclusion <p>This case represents the first documented maternal-neonatal co-infection involving both <i>L. monocytogenes</i> ST37 and ST378 strains in China. The atypical clinical manifestations observed in the pregnant woman underscore the critical importance of a multifaceted diagnostic strategy integrating clinical evaluation, microbiological testing, and imaging. Furthermore, our findings advocate for the standardized implementation of WGS in the management of perinatal listeriosis to enhance diagnostic accuracy and support national pathogen surveillance networks.</p> Clinical trial number <p>Not applicable.</p>

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Listeria monocytogenes of two sequence types in a maternal-fetal listeriosis: clinical management and bacterial genomics

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月21日

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  • Zengbin Liu,
  • Yan Wang,
  • Changle Wang,
  • Li Liu,
  • Xiaoyi Li,
  • Guilian Li,
  • Honglian Wei,
  • Zhirong Li,
  • Jianhong Zhao,
  • Jingrui Zhang

摘要

Background

Listeria monocytogenes, a foodborne pathogen of particular concern in perinatal medicine, can cause severe maternal-fetal infections with high neonatal mortality rates. This study provides detailed temporal documentation of disease progression and therapeutic interventions and elucidates the genomic profiles of these clinical isolates.

Method

A retrospective analysis was conducted on the clinical data of a pregnant woman and her neonate. Isolates obtained from maternal and neonatal specimens underwent whole genome sequencing (WGS), followed by multi-locus sequence typing (MLST), core genome phylogenetic analysis, virulence gene profiling, and antimicrobial susceptibility testing.

Results

This case manifested as maternal febrile placentitis progressing to neonatal congenital infection and respiratory distress syndrome. Targeted antimicrobial therapy (maternal ampicillin; neonatal meropenem/amoxicillin-clavulanate) achieved full clinical resolution. Genomic investigations identified concurrent infection with two sequence type strains: (a) ST37/CC37 (mother-neonate pair) clustering with European clinical isolates; (b) ST378/CC19 (maternal bloodstream) showing genetic proximity to a clinical strain from Beijing. While all strains exhibited congruent susceptibility profiles (ampicillin, meropenem, penicillin, trimethoprim-sulfamethoxazole, erythromycin) and lacked acquired resistance genes, ST378 uniquely harbored the inlP4 virulence gene absent in ST37.

Conclusion

This case represents the first documented maternal-neonatal co-infection involving both L. monocytogenes ST37 and ST378 strains in China. The atypical clinical manifestations observed in the pregnant woman underscore the critical importance of a multifaceted diagnostic strategy integrating clinical evaluation, microbiological testing, and imaging. Furthermore, our findings advocate for the standardized implementation of WGS in the management of perinatal listeriosis to enhance diagnostic accuracy and support national pathogen surveillance networks.

Clinical trial number

Not applicable.