2023-11-23 11:35:51
A team of scientists and doctors followed the development of children infected with the Listeria monocytogenes bacteria up to the age of 5 © Photo by Marisa Howenstine on Unsplash
Neonatal listeriosis is a serious illness that can cause miscarriage, premature birth or serious infection of the fetus in pregnant women. But what are the longer-term consequences of neonatal listeriosis on the health of newborns? For the first time, a team of scientists and doctors from the Pasteur Institute, Paris Cité University, AP-HP and Inserm followed the development of infected children up to the age of 5. by bacteria Listeria monocytogenes and compared it to that of uninfected children born at the same term. This study showed that The following-effects of neonatal listeriosis are mainly attributable to prematurity. These results, published in the journal The Lancet Child and Adolescent Healthon October 20, 2023, will make it possible to better inform parents regarding the evolution of the state of health of their children and to anticipate the occurrence of possible neurodevelopmental following-effects.
Of food origin, listeriosis is now well known to pregnant women who are recommended to avoid raw milk cheeses, cold meats and uncooked catering preparations during their pregnancy. And if attention is sustained, it is because the consequences can be serious: the bacteria Listeria monocytogenes can in fact cause abortion, premature birth and/or serious infection in the newborn (sepsis, pulmonary infection, neurological). In France, around 40 newborns are affected each year.
« Since 2009, we have been studying all strains of Listeria and all patients in France – listeriosis being a notifiable disease – in order to better understand the characteristics of this pathology. One of the questions that was asked was how children with neonatal listeriosis, and cured with antibiotics, grew and developed », explains Marc Lecuit, head of the National Reference Center Listeria and the Biology of Infections unit (Institut Pasteur/Université Paris Cité/Inserm), Professor of Infectious Diseases at the University Paris Cité and the Necker-Enfants Malades Hospital, and co-principal author of the study.
This is how the team of scientists and doctors relied on the French MONALISA cohort which recruits all confirmed cases of listeriosis to study the long-term neurological and neurodevelopmental consequences of the infection in surviving children. This demanding follow-up work, made possible thanks to the active participation of families, offered an unprecedented vision of the consequences of neonatal listeriosis on the neurocognitive development of children at a key age, that of entry into primary school. The multidisciplinary team made up of infectious disease specialists, pediatricians, neuropsychologists and epidemiologists was able to follow around fifty children born to mothers who contracted listeriosis at different stages of pregnancy, and comprehensively assess their health status at the age 5 years old.
The cognitive domain was assessed using the French version of the Wechsler Preschool and Primary Intelligence Scale, and the motor and visual domain using a physical examination designed to screen for cerebral palsy and coordination disorders. . Interviews with parents and medical examinations also tested hearing, communication and socialization functions. The results obtained were compared to those of uninfected children of the same gestational age from two large contemporary national cohorts: the EPIPAGE-2 (premature children) and ELFE (full-term children) cohorts.
This comparative approach made it possible to demonstrate that children born with listeriosis present, at the age of 5 years, following-effects (cognitive disorders, motor coordination problems, visual or hearing deficit) in two thirds of cases, mainly attributable to to their prematurity.
« We can now say that the following-effects of neonatal listeriosis are mainly due to prematurity rather than infection. These results will allow clinicians to provide parents of newborns with listeriosis with substantiated medical advice, and to inform them regarding the evolution of their child’s health.. They also call for the implementation of systematic and prolonged screening for possible following-effects in order to provide appropriate early care, accompanied by appropriate educational support. », concludes Caroline Charlier, researcher in the Biology of Infections unit (Institut Pasteur/Université Paris Cité/Inserm) and Professor of Infectious Diseases at Paris Cité University and Cochin Hospital, first author and coordinator of the study.
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