Cómo afecta la listeria al embarazo

Los bebés nacidos de madres que se infectan con listeria al final del embarazo suelen nacer de forma prematura y tienden a presentar insuficiencia respiratoria con neumonía.
Cómo afecta la listeria al embarazo
María Vijande

Escrito y verificado por la farmacéutica María Vijande el 27 septiembre, 2019.

Última actualización: 27 septiembre, 2019

La infección por listeria se adquiere por la ingesta de alimentos contaminados. Se trata de una bacteria resistente a las bajas temperaturas. En una mujer embarazada, una vez ingerido el alimento contaminado, la listeria se absorbe en el aparato digestivo y llega a la placenta, uno de sus tejidos preferidos. ¿Cuáles son sus consecuencias?

¿Cuales son los síntomas de la infección por listeria?

bacterias
Los síntomas de la infección por listeria suelen ser inespecíficos. Sin embargo, en el caso de las mujeres embarazadas es de gravedad, ya que puede causar consecuencias en el feto.

Los síntomas de esta infección son inespecíficos, pudiendo aparecer malestar y fiebre como si se tratase de una gripe. No obstante, en algunos casos, previamente se presenta un cuadro de síntomas gastrointestinales como náuseas y dolor abdominal.

En condiciones normales, se trata de un cuadro inespecífico sin más importancia. Sin embargo, en el caso de mujeres embarazadas es grave por las consecuencias que puede tener para el bebé.

Si se adquiere la infección en primer o segundo trimestre de la gestación, en muchos casos se suele producir un aborto o una muerte fetal intraútero.

Del 80% de casos en que se produce en el tercer trimestre, en una tercera parte es totalmente asintomática para la madre y para el bebé. Sin embargo, en dos terceras partes se produce una infección del líquido amniótico y un parto prematuro, con una mortalidad del bebé de alrededor de un 20%.

¿Cómo se contagia el bebé?

Los bebés nacidos de madres que se infectan con listeria al final del embarazo pueden contagiarse de dos formas:

  • Por contagio en el canal del parto: en estos casos aparece sobre el séptimo día de vida. Con frecuencia, los bebés presentan meningitis.

Diagnóstico de la infección por listeria en el embarazo

En ocasiones, es muy difícil de diagnosticar, ya que los síntomas son muy comunes en muchas enfermedades. El diagnóstico se realiza mediante el aislamiento de la bacteria en la embarazada, la placenta o el neonato,

En el primer y segundo trimestre de embarazo puede dar síntomas parecidos a la gripe, con fiebre y síntomas gastrointestinales. Sin embargo, en el tercer trimestre suele presentarse como un cuadro de fiebre, dolor uterino y contracciones.

Tratamiento

Mujer embarazada en el médico
Ante la sospecha de listeria en la embarazada, es primordial iniciar el tratamiento con antibióticos lo antes posible. A menudo,se elegir ampicilina intravenosa.

El tratamiento de elección es ampicilina intravenosa en dosis de 1g/8h durante al menos 10 días. Posteriormente, se continua por vía oral hasta completar 3 semanas de tratamiento. Además, se administra un aminoglucósido intravenoso en dosis de 3mg/kg en una sola inyección diaria durante 5 días.

La aplicación adecuada del tratamiento antibiótico mejora de forma notable el pronóstico y puede evitar la infección neonatal. Ante la sospecha de una infección por listeria en una embarazada, se debe iniciar el tratamiento antibiótico antes de tener los resultados de los cultivos para no perder tiempo.

¿Cómo se puede prevenir la infección por listeria?

La profilaxis debe tener en cuenta todos los eslabones de la cadena de contaminación. La medida preventiva más importante es la información a las gestantes sobre el riesgo de infección relacionado con la alimentación y las medidas higiénicas.

Sobre todo, conviene ser muy cuidadosos con la comida y tener en cuenta que la listeria es resistente a la congelación. Sin embargo, esta bacteria se destruye por encima de 50 º. A continuación, te damos una serie de recomendaciones para prevenir la infección por listeria:

  • Cocinar todos los alimentos de origen animal por encima de 50º y tomar lácteos pasteurizados.
  • Lavar bien los alimentos que se consuman crudos. También debes lavarte las manos, los utensilios de cocina y las superficies de la cocina después de manipular alimentos crudos.
  •  Limpiar a menudo la nevera y no juntar alimentos crudos con los cocinados.
  •  No conservar mucho tiempo los productos de charcutería después de abiertos.

Alimentos no recomendados en el embarazo

Los alimentos de más riesgo de contagiarse por listeria y que, por tanto, no se recomiendan a las embarazadas son:

  • Quesos blandos que no son pasteurizados, tipo brie o camembert.
  • Leche no pasteurizada.
  • Salchichas tipo Frankfurt si no se calientan bien por encima de 50ºC.
  • Pescado y marisco crudo.
  • Ensaladas compradas ya listas para comer. Antes de consumirlas se recomienda lavarlas bien.

Conclusión

La importancia de la listeriosis deriva de las graves consecuencias que un diagnóstico tardío puede tener en la evolución de la gestación. Por lo que es importante tenerla presente ante cualquier proceso febril sin foco aparente durante el embarazo.

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  • Raimond, E., Graesslin, O., & Gabriel, R. (2013). Listeriosis en el embarazo. EMC - Ginecología-Obstetricia. https://doi.org/10.1016/s1283-081x(13)64080-1
  • Gutiérrez Romero, M. P., & García  Rumí, V. M. (2016). Listeriosis en el embarazo. Papel de la matrona en la prevención de la enfermedad. Hygia de Enfermería: Revista Científica Del Colegio.
  • Chaparro Sánchez, M. J., Curiel Balsera, E., Prieto Palomino, M. A., Weil Lara, B., Ruiz De Elvira, M. J., & Fernández Zamora, M. D. (2004). Listeriosis en gestante con muerte fetal intraútero. Medicina Intensiva.

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