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Listeria monocytogenes infections: laboratory investigation of an unexpected increase in incidence.

Listeria monocytogenes is a facultative intracellular pathogen causing mainly meningitis and septicemia in immunocompromised hosts. From July 1988 through December 1989, 16 patients at The Mount Sinai Hospital were diagnosed as having listeriosis shortly after admission, 14 within a one-year period (July 1988-July 1989). Because this incidence was almost double the incidence in previous years (< 8 annually), an epidemiologic and microbiologic investigation was undertaken to determine a potential route of acquisition of L. monocytogenes. On the basis of plasmid profile, bacteriocin (enterocin) susceptibility pattern, and serotype, no single epidemic strain could be identified. Although direct evidence was lacking, we concluded that our patients may have acquired L. monocytogenes through transient contamination of food.

Bacterial Typing Techniques↗

Dysregulation of interleukin-10 and interleukin-12 are involved in the reduced host resistance to Listeria monocytogenes infection in alymphoplastic aly mutant mice.

The aly is a unique spontaneous autosomal recessive mutation in mice that causes a systemic defect of lymph nodes and Peyer's patches and disorganized splenic and thymic structures with immunodeficiency. Our previous study demonstrated that resistance to Listeria monocytogenes infection and interferon-gamma (IFN-gamma) production are attenuated in the mutant mice. In this study, we investigated the mechanism of decrease in antilisterial resistance and IFN-gamma production in aly mice. Interleukin (IL)-12 production in response to heat-killed L. monocytogenes (HK-LM) was decreased but IL-10 production was increased in aly/aly macrophage cultures, compared with those in aly/+ macrophages. Nonadherent cells and macrophages obtained from the spleens of naive aly/+ mice and aly/aly mice were reconstituted and stimulated with HK-LM. IFN-gamma production was markedly decreased when macrophages derived from aly/aly mice were used. IFN-gamma production in aly/aly spleen cell cultures was recovered in the presence of anti-IL-10 monoclonal antibody (mAb) or recombinant IL-12. When aly/+ mice and aly/aly mice were injected with mAb against IL-10 or IL-12 p40, antilisterial resistance was inhibited by injection of anti-IL-12 p40 mAb, while anti-IL-10 mAb treatment augmented the resistance. Administration of anti-IFN-gamma mAb attenuated antilisterial resistance in aly/+ mice but not in aly/aly mice. The present results suggest that downregulation of IL-12 and upregulation of IL-10 in macrophages might be involved in the decrease in antilisterial resistance and IFN-gamma production in aly/aly mice in addition to the structural defect in lymphoid organs. Moreover, the results predict that an IL-12-dependent and IFN-gamma-independent mechanism may be also involved in the decrease in antilisterial resistance in aly/aly mice.

Animals↗

Impairment of host resistance to Listeria monocytogenes infection in liver of db/db and ob/ob mice.

Leptin is an adipocyte-derived hormone that regulates a number of physiological functions, including energy homeostasis and immune function. In immune responses, leptin plays a role in the induction of inflammation. We investigated a role of leptin in Listeria monocytogenes infection using leptin receptor-deficient db/db mice and leptin-deficient ob/ob mice. These mutant mice were highly susceptible to L. monocytogenes, and the elimination of bacteria from the liver was inhibited. After infection, the induction of monocyte chemoattractant protein-1 (MCP-1) and KC mRNA in the liver of db/db mice and the MCP-1 mRNA expression in the liver of ob/ob mice was decreased compared with their heterozygote littermates. Leptin replacement in ob/ob mice resulted in improvement of anti-listerial resistance and the MCP-1 mRNA expression. The elimination of L. monocytogenes was significantly enhanced, and the expression of MCP-1 and KC mRNA was completely reversed in db/db mice by insulin treatment. These results suggest that leptin is required for host resistance to L. monocytogenes infection and that hyperglycemia caused by leptin deficiency is involved in the inefficient elimination of bacteria from the liver. Moreover, defect of MCP-1 expression in the liver may be involved in the attenuated host resistance in these mutant mice.

Animals↗

[Resistance to infection with Listeria monocytogenes in normal and thymusless mice treated with ampicillin (author's transl)].

NMRI mice were infected intravenously with a sublethal dose of Listeria monocytogenes and divided into four groups. One group served as the control and the other three were treated with ampicillin beginning 4, 8 or 24 hours after infection. The animals were injected in the morning and in the evening each time with 4 mg ampicillin subcutaneously until a total dose of 48 mg was reached. As demonstrated by counting of the bacteria in the spleen, Listeria could multiply in the ampicillin treated mice in comparison to the control group at best delayed but the infection continued to persist for some days at a level of 10(3)-10(4) Listeriae per spleen independent from the starting point of the treatment. Eight days after the first infection all animals received a challenge dose of 10(4) Listeriae. Compared with the control animals the ampicillin treated mice had a clearly reduced immunity, even in the group in which ampicillin application had been started 24 hours after the primary infection. If the challenge infection was given at first after an intervall of six weeks between primary and secondary infection, only a reduced immunity was found. Furthermore, whereas spleen cells of mice 7 days after infection were able to transfer immunity to untreated recipients, spleen cells of ampicillin treated mice were unable to do so. Finally, an attempt was made to cure chronic listeric infection in thymusless nude mice by the application of high doses of ampicillin. The observation of a continuous infection in these animals showed that the T-cells played a primary importance in the elimination of the bacteria.

Ampicillin↗

Analysis of cytokine mRNA expression in Listeria-resistant C57BL/6 and Listeria-susceptible A/J mice during Listeria monocytogenes infection.

This laboratory previously reported that mRNA expression for many cytokines, as determined by reverse transcription-polymerase chain reaction analysis, is induced rapidly in the spleen during murine listeriosis. In the present study, the patterns of cytokine mRNA expression in spleens and livers of Listeria-resistant C57BL/6 and Listeria-susceptible A/J mice were compared. In addition, in situ hybridization was performed to evaluate the distributions of cytokine mRNA-expressing cells in these tissues. Listeria-resistant C57BL/6 mice demonstrated greater expression of gamma interferon (IFN-gamma) and granulocyte-macrophage colony-stimulating factor (GM-CSF) mRNAs in the spleen than Listeria-susceptible A/J mice. Greater numbers of cells expressing IFN-gamma and GM-CSF mRNAs were observed by in situ hybridization in the spleens of C57BL/6 mice than in those of A/J mice. C57BL/6 and A/J mice did not differ in their expression of IFN-gamma mRNA in the liver. Nor did C57BL/6 and A/J mice differ in their expression of tumor necrosis factor alpha, interleukin-1 alpha (IL-1 alpha), IL-2, IL-4, or IL-6 mRNA in the liver or spleen, as determined by reverse transcription-polymerase chain reaction and in situ hybridization. These results indicate that the greater resistance of C57BL/6 mice to Listeria monocytogenes infection is associated with greater expression of IFN-gamma and GM-CSF mRNAs in the spleen and GM-CSF mRNA in the liver.

Animals↗

Augmentation of host defense against Listeria monocytogenes infection by oral administration with polysaccharide RBS (RON).

Protection against Listeria monocytogenes in mice was enhanced by oral administration with a 30 mg/kg/day dose of polysaccharide RBS for 10 days. In mice treated with RBS, an enhanced elimination in vivo of L. monocytogenes was observed at the relatively late phase of listerial infection in correlation with enhanced immune responses against L. monocytogenes. The peritoneal macrophages from mice treated with RBS exhibited an increased activity of accessory cells for immune responses as assessed by production of interleukin-1 and antigen presentation to Listeria-immune T-cells. An increased activity of macrophages acting as accessory cells for immune responses may play important roles in the enhanced resistance against L. monocytogenes in mice treated orally with RBS.

Actins↗

Increase of Thy-1 antigen on the thymocytes accompanied with their augmented adhesion capacity to thymic epithelial cells in the mice infected with Listeria monocytogenes.

It becomes increasingly clear that adhesion systems such as CD2/LFA-3 (lymphocyte function-associated antigen-3), LFA-1/ICAM-1 (intercellular adhesion molecule-1) and Thy-1/putative Thy-1 ligand participate in the association between murine thymocytes and thymic epithelial cells. In the present study, thymocytes showed an increase in surface Thy-1 levels in mice infected with Listeria monocytogenes, but no significant changes in the levels of CD2 or LFA-1. No alteration was found either in the ratio of CD3high/CD3low/CD3- or in that of CD4/CD8 subsets in these thymocytes compared with uninfected control thymocytes which excluded the possibility of enrichment of 'cortical thymocytes' with Thy-1high/CD3low/CD4+ CD8+ in the thymocyte population of infected mice. Moreover such Thy-1high thymocytes exhibited a highly augmented ability of adhesion to a thymic epithelial cell line due to the increase of surface Thy-1 antigens as an adhesion molecule. At such intervals after infection, the total number of thymocytes was found to be reduced. These results suggest that the expression level of surface Thy-1 on thymocytes is regulated in response to in vivo stimulation and may play a role in the intrathymic development of thymocytes by affecting the adhesion of thymocytes with thymic stromal cells. The implication of the enhanced ability of adhesion in the decrease in the number of thymocytes is discussed.

Animals↗

Comparative activity of quinolones (ciprofloxacin, levofloxacin, moxifloxacin and garenoxacin) against extracellular and intracellular infection by Listeria monocytogenes and Staphylococcus aureus in J774 macrophages.

OBJECTIVES: Quinolones accumulate in eukaryotic cells and show activity against a large array of intracellular organisms, but systematic studies aimed at examining their pharmacodynamic profile against intracellular bacteria are scarce. The present work aims at comparing intracellular-to-extracellular activities in this context. METHODS: We assessed the activities of ciprofloxacin, levofloxacin, moxifloxacin and garenoxacin against the extracellular (broth) and intracellular (infected J774 macrophages) forms of Listeria monocytogenes (cytosolic infection) and Staphylococcus aureus (phagolysosomal infection) using a range of clinically meaningful extracellular concentrations (0.06-4 mg/L). RESULTS: All four quinolones displayed concentration-dependent bactericidal activity against extracellular and intracellular L. monocytogenes and S. aureus for extracellular concentrations in the range 1-4-fold their MIC. Compared at equipotent extracellular concentrations, intracellular activities against L. monocytogenes were roughly equal to those that were extracellular, but were 50-100 times lower against S. aureus. Because quinolones accumulate in cells (ciprofloxacin, approximately 3 times; levofloxacin, approximately 5 times; garenoxacin, approximately 10 times, moxifloxacin, approximately 13 times), these data show that, intracellularly, quinolones are 5-10 times less potent against L. monocytogenes (P=0.065 [ANCOVA]), and at least 100 times less potent (P < 0.0001) against S. aureus. Because of their lower MICs and higher accumulation levels, garenoxacin and moxifloxacin were, however, more active than ciprofloxacin and levofloxacin when compared at similar extracellular concentrations. CONCLUSIONS: Quinolone activity is reduced intracellulary. This suggests that either only a fraction of cell-associated quinolones exert an antibacterial effect, or that intracellular activity is defeated by the local environment, or that intracellular bacteria only poorly respond to the action of quinolones.

Animals↗

Differential requirements for the chemokine receptor CCR7 in T cell activation during Listeria monocytogenes infection.

Effective priming of T cell responses depends on cognate interactions between naive T cells and professional antigen-presenting cells (APCs). This contact is the result of highly coordinated migration processes, in which the chemokine receptor CCR7 and its ligands, CCL19 and CCL21, play a central role. We used the murine Listeria monocytogenes infection model to characterize the role of the CCR7/CCR7 ligand system in the generation of T cell responses during bacterial infection. We demonstrate that efficient priming of naive major histocompatibility complex (MHC) class Ia-restricted CD8+ T cells requires CCR7. In contrast, MHC class Ib-restricted CD8+ T cells and MHC class II-restricted CD4+ T cells seem to be less dependent on CCR7; memory T cell responses are independent of CCR7. Infection experiments with bone marrow chimeras or mice reconstituted with purified T cell populations indicate that CCR7 has to be expressed on CD8+ T cells and professional APCs to promote efficient MHC class Ia-restricted T cell priming. Thus, different T cell subtypes and maturation stages have discrete requirements for CCR7.

Animals↗

[Hematologic and histochemical changes in the bodies of sheep experimentally infected with listeriae].

Hematologic and histologic investigations were carried out on forty experimentally infected young ewes to which the infection was introduced through venous, intratracheal, and oral route as well as along the branches of nervus trigeminus parallel to the study of 3 control sheep, 12 albino mice, and other four young sheep that were injected with a water-extractive antigen obtained from Listeria. It was established that the leukocyte count rose in the first days following infection along with neutrophilia, lymphopenia, and monocytosis of a varying degree in the different animals, depending on the way of infection. Most indifferent with regard to the hematologic indices proved animals that were orally inoculated. With such animals there was also eosinophilia, which was lacking in the other experimental animals. Glycogen was predominantly found in the blood vessel walls, in the neutrophile leukocytes, the nervous tissue, and the necrotic foci, most likely in connection with the transportation of Listerial organisms and their toxic products. A drop up to the full disappearance of phospholipids was established as well as a rise of the ganglioside.

Animals↗

Host resistance to an intragastric infection with Listeria monocytogenes in mice depends on cellular immunity and intestinal bacterial flora.

Suckling and adult mice were infected intragastrically with different doses of viable Listeria monocytogenes. The 50% lethal dose for the intragastric infection was 10(3.7) CFU for suckling mice, while adult mice were highly resistant and the 50% lethal dose was more than 10(9.3) CFU. When adult mice were infected intragastrically with 5 x 10(8) CFU of L. monocytogenes, no mice died. However, 35% of adult mice died when they were treated with cyclosporin A 1 day before infection. Although mice did not die when treated with an L. monocytogenes-resistant broad-spectrum cephalosporin, sodium cefbuperazone, before and during infection, the number of L. monocytogenes bacteria increased in the feces. The sodium cefbuperazone treatment of mice resulted in superinfection, i.e., a marked decrease of Escherichia coli and an increase of Enterococcus spp. in the intestines. Furthermore, host resistance against the intragastric infection markedly decreased when the mice were treated with both drugs. The growth of L. monocytogenes was augmented in the spleens, mesenteric lymph nodes, Peyer's patches, and feces, and the mortality of the mice was 65%. These results suggest that both cellular immunity and the intestinal bacterial flora are required for host resistance against oral L. monocytogenes infection.

Animals↗

Modulation of hepatic cytochrome P450 during Listeria monocytogenes infection of the brain.

Hepatic cytochrome P450 enzymes can be modulated during systemic infections. Inflammatory responses in the brain have also been shown to cause a significant decrease in the levels and activities of important cytochrome P450 isoforms in the liver. We determined some of the effects of central nervous system (CNS) Listeria monocytogenes infection on hepatic cytochrome P450 systems in rats. Intracerebroventricular injection of L. monocytogenes resulted in a time-dependent modulation of CYP1A, CYP2B, and CYP3A activities in the liver. Total hepatic cytochrome P450 content was significantly lowered 48 h after administration of the bacterium, and hepatic CYP1A and CYP2B activities were significantly altered 48 and 72 h after infection, respectively, whereas CYP3A activity and protein content were depressed 72 h after the insult. Bacterial load in the brain increased dramatically over a 72-h period, but the number of bacteria cultured from liver over this time period was relatively small. Therefore, an infection largely confined to the CNS in the rat results in abnormal activity levels of certain hepatic cytochrome P450 enzymes crucial in drug metabolism. If such a response also occurs in humans, this has the potential to produce serious complications with drug and endogenous substrate metabolism in patients with an infectious disease involving the CNS.

Animals↗

Comparative study of protective effects of chitin, chitosan, and N-acetyl chitohexaose against Pseudomonas aeruginosa and Listeria monocytogenes infections in mice.

We conducted a comparative study of the protective effects of chitin, chitosan, and N-acetyl chitohexaose (NACOS-6) against mice infected intravenously or intraperitoneally with Pseudomonas aeruginosa and Listeria monocytogenes. Mice pretreated with chitin, chitosan, and NACOS-6 showed resistance to intraperitoneal infections by both microbes. Only mice pretreated with chitin and chitosan showed resistance to intravenous infections by both microbes. The number, active oxygen generation, and myeloperoxidase activity of peritoneal exudate cells (PEC) in the chitin, chitosan, and NACOS-6-treated mice were greater than those of the untreated mice. Also, these PEC factors from mice pretreated with chitin and chitosan were greater than those from the NACOS-6-treated mice.

Adjuvants, Immunologic↗

Indoleamine 2,3-dioxygenase-expressing dendritic cells form suppurative granulomas following Listeria monocytogenes infection.

Control of pathogens by formation of abscesses and granulomas is a major strategy of the innate immune system, especially when effector mechanisms of adaptive immunity are insufficient. We show in human listeriosis that DCs expressing indoleamine 2,3-dioxygenase (IDO), together with macrophages, are major cellular components of suppurative granulomas in vivo. Induction of IDO by DCs is a cell-autonomous response to Listeria monocytogenes infection and was also observed in other granulomatous infections with intracellular bacteria, such as Bartonella henselae. Reporting on our use of the clinically applied anti-TNF-alpha antibody infliximab, we further demonstrate in vitro that IDO induction is TNF-alpha dependent. Repression of IDO therefore might result in exacerbation of granulomatous diseases observed during anti-TNF-alpha therapy. These findings place IDO(+) DCs not only at the intersection of innate and adaptive immunity but also at the forefront of bacterial containment in granulomatous infections.

Antigens, CD↗

Primary Listeria monocytogenes infection in gestating mice.

The facultative intracellular Gram-positive bacterium Listeria monocytogenes is a food-borne pathogen of frequently underestimated importance. Pregnant women represent the high-risk group for L. monocytogenes infection. Abortion, stillbirth or neonatal infection can be the serious outcome of such an infection. Recovery from listeriosis, resistance mechanisms of the host and the effect of L. monocytogenes on fetal development still remain to be fully understood. The results of our experiments showed an increased susceptibility of gestating BALB/c mice to primary L. monocytogenes infection. The duration of listeriosis in gestating animals was almost twice longer than in the control group. Furthermore, it was clearly shown that the detrimental effect of L. monocytogenes on fetal development was more pronounced if the infection was acquired earlier during gestation.

Animals↗

IL-10 is required for optimal CD8 T cell memory following Listeria monocytogenes infection.

IL-10 is an important immunoregulatory cytokine that plays a central role in maintaining a balance between protective immunity against infection and limiting proinflammatory responses to self or cross-reactive Ags. We examined the full effects of IL-10 deficiency on the establishment and quality of T cell memory using murine listeriosis as a model system. IL-10(-/-) mice had reduced bacterial loads and a shorter duration of primary infection than did wild-type mice. However, the number of Ag-specific T cells in secondary lymphoid and nonlymphoid organs was diminished in IL-10(-/-) mice, compared with wild-type mice, at the peak of the effector response. Moreover, the frequency and protective capacity of memory T cells also were reduced in IL-10(-/-) mice when assessed up to 100 days postinfection. Remarkably, this effect was more pronounced for CD8 T cells than CD4 T cells. To address whether differences in the number of bacteria and duration of primary infection could explain these findings, both strains of mice were treated with ampicillin 24 hours after primary infection. Despite there being more comparable bacterial loads during primary infection, IL-10(-/-) mice still generated fewer memory CD8 T cells and were less protected against secondary infection than were wild-type mice. Finally, the adoptive transfer of purified CD8 T cells from previously infected wild-type mice into naive recipients conferred better protection than the transfer of CD8 T cells from immune IL-10(-/-) mice. Overall, these data show that IL-10 plays an unexpected role in promoting and/or sustaining CD8 T cell memory following Listeria monocytogenes infection.

Adoptive Transfer↗

Ability of orally administered IFN-alpha-containing transgenic potato extracts to inhibit Listeria monocytogenes infection.

Type I interferons (IFN-alpha/beta) were originally thought to be antiviral cytokines, but it has recently been reported that they also play an important role in potentiating innate and adaptive immune responses. Moreover, several studies have shown that the oral administration of type I IFN ameliorates various biologic activities. Here, we studied the ability of orally administered IFN-alpha to protect mice from systemic Listeria monocytogenes infection. Daily oral administration of purified natural IFN-alpha at a concentration of 1000 international units (IU)/20 microl reduced the bacterial burden in infected organs. We also examined the protective effect of IFN-alpha expressed in transgenic potato plants. A much lower concentration of IFN-alpha (20 IU/ 20 microl) in the plant extracts was almost as protective as much higher concentrations of purified natural IFN-alpha. Our observations indicate that transgenic cytokine-expressing plants can be used prophylactically as edible pharmaceuticals to enhance systemic defense responses in humans and animals.

Administration, Oral↗