In Central nervous system (CNS) infection cases, ''L. monocytogenes'' can often be cultured from the blood, and always cultured from the CSF. There are no reliable serological or stool tests.
Bacteremia should be treated for 2 weeks, meningitis for 3 weeks, and brain abscess for at least 6 weeks. Ampicillin generally is considered antibiotic of choice; gentamicin is added frequently for its synergistic effects.
Overall mortality rate is 20–30%; of all pregnancy-related cases, 22% resulted in fetal loss or neonatal death, but mothers usually survive.
The main means of prevention is through the promotion of safe handling, cooking and consumption of food. This includes washing raw vegetables and cooking raw food thoroughly, as well as reheating leftover or ready-to-eat foods like hot dogs until steaming hot.
Another aspect of prevention is advising high-risk groups such as pregnant women and immunocompromised patients to avoid unpasteurised pâtés and foods such as soft cheeses like feta, Brie, Camembert cheese, and bleu. Cream cheeses, yogurt, and cottage cheese are considered safe. In the United Kingdom, advice along these lines from the Chief Medical Officer posted in maternity clinics led to a sharp decline in cases of listeriosis in pregnancy in the late 1980s.
Intralytix, a Maryland-based biotechnology firm, has received FDA approval for a product, ListShield, that is proven effective in eliminating ''Listeria monocytogenes'' bacteria using a preparation containing six listeria-specific bacteriophages. The product is an aqueous solution that is sprayed directly onto food or surfaces used in food production. It is odorless and tasteless.
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