Listeriosis laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]

Overview

For symptomatic patients, diagnosis is confirmed only after isolation of Listeria monocytogenes from a normally sterile site, such as blood, spinal fluid (in the setting of nervous system involvement), or amniotic fluid/placenta (in the setting of pregnancy). Stool samples are of limited use and are not recommended. Listeria monocytogenes may be isolated readily on routine media, but distinguishing Listeria from other Gram-positive organisms (such as diphtheroids) may be difficult. Selective enrichment media improve rates of isolation from contaminated specimens. The cultures typically require 1-2 days for growth. A negative culture does not rule out infection in the presence of strong clinical suspicion. Serological tests are unreliable and currently not recommended. Laboratory testing on asymptomatic patients (including high-risk asymptomatic patients) is not recommended.[1]

Laboratory Tests

Cell Culture

  • Listeria grows on media such as Mueller-Hinton agar.[2]
  • Identification is enhanced if the primary cultures are done on agar containing sheep blood because the characteristic small zone of hemolysis can be observed around, and under the colonies.
  • Isolation can be enhanced if the tissue is kept at 4°C for some days before inoculation into bacteriologic media.
  • The motility at room temperature and hemolysin production are primary findings that help differentiate listeria from coryneform bacteria.

Stool Cultures

  • Stool cultures are not indicated in systemic listeriosis patients because routine culture media for enteric pathogens are not appropriate for the growth of Listeria.
  • In cases of outbreaks of listeriosis or individual patients with suspected listerial gastroenteritis, special selected media can be used.

Anton Test

References

  1. "Listeria".
  2. Chapter 13. Non-Spore-Forming Gram-Positive Bacilli: Corynebacterium, Propionibacterium, Listeria, Erysipelothrix, Actinomycetes, & Related Pathogens ,Jawetz, Melnick, & Adelberg's Medical Microbiology, 24th Edition ,The McGraw-Hill Companies


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