肖玲 邹丽颖

[摘要] 单核细胞增多性李斯特氏菌属于李斯特氏菌属，为人畜共患的致病菌，人类主要是通过食用被污染食品而感染，感染后可导致李斯特菌病。该病原菌可产生一种溶血性外毒素，对人类有很强的致病性，常见于免疫功能低下的者，如妊娠、老年人、免疫缺陷者以及胎儿、新生儿（通过母婴垂直传播或少数者通过阴道分娩时感染）等。人体感染后可引起菌血症、败血症、脑膜炎及流产等症状，因其症状不典型，导致诊断困难。李斯特菌病有较高的死亡率。本文旨在阐述妊娠期单核细胞增多性李斯特菌感染及对母儿的影响，以改善妊娠结局。

[关键词] 菌血症；单核细胞增多性李斯特氏菌；李斯特菌病；流行病学；妊娠

[中图分类号] R714 [文献标识码] A [文章编号] 1673-7210（2018）05（c）-0030-04

Listeria Monocytogenes infection in pregnancy and its impact on mother and infant

XIAO Ling1 ZOU Liying2▲

1.Department of Obstetrics， the First Maternal and Child Health Hospital of Dongchen District， Beijing 100007， China； 2.Department of Obstetrics， Beijing Obstetrics and Gynaecology Hospital， Capital Medical University， Beijing 100026，China

[Abstract] Listeriosis is an anthropozoonosis caused by Listeria monocytogenes （L. monocytogenes）. It is acquired by humans primarily through consumption of contaminated food. Listeria monocytogenes has strong pathogenicity to human through produced the hemolytictoxin， especially high risk patients such as pregnant women， elderly people， immuno compressed people， unborn babies， andneonates （through vertical transmission from the mother or， more rarely， at birth by ascending colonisation from the vagina）. Infection causes a spectrum of illness， including bacteraemia， sepsis， meningoencephalitis and abortion， but symptoms are nonspecific and diagnosis is difficult. Alsolisteriosishas a highmortality. The aim of this review article is to introduced the relationship between it and pregnacy， so as to improve the pregnancy outcome.

[Key words] Bacteraemia； Listeria monocytogenes； Listeriosis； Epidemiology； Pregnancy

單核细胞增多性李斯特菌（Listeriamonocytogenes，LM）又称为李斯特菌，属于革兰阳性杆菌，在自然界中广泛存在，是导致人体李斯特菌病（Listeriosis diseases）的唯一病原体。其进入人体后是否致病与菌量和宿主的年龄、免疫状态有关，易感人群为新生儿、孕妇、老人和免疫功能缺陷者。有研究报道，妊娠期妇女感染李斯特菌的风险较普通人群高13倍[1]。妊娠期感染LM会导致流产、胎死宫内或死产、早产、绒毛膜羊膜炎、孕妇和新生儿败血症[2-3]，且被感染的胎儿和新生儿预后极差，病死率高达25%～30%[4]。据WHO统计欧洲国家每年发生LM的感染率为每10万人0.3～7.5例，而在孕妇中发生率更高，为每10万人12例[5]。本文旨在对妊娠期感染LM对母儿的影响及LM特点进行综述。……