Fascinating...

Listeria monocytogenes is a bacterial pathogen that can cause invasive disease in predisposed individuals, including pregnant women and immunocompromised individuals. During pregnancy, listeriosis leads to spontaneous abortion, preterm labor, or neonatal disease. Tropism of L. monocytogenes to the placenta and maternal immunosuppression, have been hypothesized to be the cause of the susceptibility to listeriosis during pregnancy. This study presents a series of experiments in a pregnant guinea pig model of listeriosis and mathematical simulation of the infection, which led the authors to propose a new model. A single bacterium is sufficient to cause placental infection. Due to decreased clearance in the placenta there is a strong increase of bacteria in the placental compartment, which becomes a nidus of infection leading to continuous seeding of maternal organs. Thus, the increase of bacteria in maternal organs is not due to immunosuppression but to efflux of L. monocytogenes from the placenta. This process will be interrupted by expulsion of the infected feto-placental tissues. Therefore, spontaneous abortion and prematurity can be regarded as survival mechanisms for the mother. Furthermore, this study hypothesizes that expulsion of the infected placenta may be important for the natural history of listeriosis.

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Even more fascinating (and frustrating)...

The study is the first to trace such a pathway of infection, and it dashes the widely-held assumption that immune-system changes during pregnancy are to blame for elevated Listeria infection rates.

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