International journal of women's health · 2026
Molecular Characterization of Listeria monocytogenes Associated with Adverse Pregnancy Outcomes in Iraq with Whole-Genome Analysis of a Representative Isolate.
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Hamad Noor Abdulla, Hassan Al-Alouci Muntaha Maddah, Zaidan Susan Abed
Аннотация
BACKGROUND: Pregnancy-associated listeriosis can cause severe fetal and obstetric complications, yet molecular epidemiological data from Iraq remain limited. This study integrated clinical and epidemiological data with PCR-based virulence profiling of Listeria monocytogenes isolates and whole-genome sequencing (WGS) of one representative clinical isolate.
METHODS: In this prospective cross-sectional study, 150 pregnant women presenting with spontaneous abortion, stillbirth/intrauterine fetal death, or preterm labor were enrolled. L. monocytogenes isolates were characterized by culture, biochemical testing, 16S rRNA PCR, and PCR screening of hlyA, actA, inlA, and inlB. One representative isolate (A125-2) was subjected to WGS on the BGISEQ-500 platform for sequence typing, virulence and antimicrobial-resistance gene profiling, and phylogenomic placement.
RESULTS: L. monocytogenes was isolated from 18/150 participants (12.0%; 95% CI, 7.3-18.1%), with the highest positivity among spontaneous abortion cases (14.3%). PCR detected hlyA, actA, and inlA in all 18 isolates and inlB in 12/18 (66.7%). The sequenced representative isolate A125-2 was assigned to Sequence Type 1 (ST1) and Clonal Complex 1 (CC1) and carried LIPI-1, LIPI-3, multiple internalin genes, stress-response determinants, and several antimicrobial-resistance-associated genes. WGS also detected inlB in A125-2 despite the PCR discrepancy. Descriptively, 28.7% of participants reported unpasteurized dairy exposure, and 61.1% of L. monocytogenes-positive cases occurred during winter.
CONCLUSION: The clinical and PCR findings support an association between L. monocytogenes and adverse pregnancy outcomes in this Iraqi cohort. Genomic characterization of one representative isolate demonstrated an ST1/CC1 background with multiple virulence and stress-adaptation determinants and illustrated the added resolution of WGS for investigating PCR discrepancies. Because only one isolate underwent WGS, the genomic findings should be interpreted as isolate-specific and not as population-level evidence for Iraqi L. monocytogenes strains. Broader multi-isolate genomic surveillance is warranted.
METHODS: In this prospective cross-sectional study, 150 pregnant women presenting with spontaneous abortion, stillbirth/intrauterine fetal death, or preterm labor were enrolled. L. monocytogenes isolates were characterized by culture, biochemical testing, 16S rRNA PCR, and PCR screening of hlyA, actA, inlA, and inlB. One representative isolate (A125-2) was subjected to WGS on the BGISEQ-500 platform for sequence typing, virulence and antimicrobial-resistance gene profiling, and phylogenomic placement.
RESULTS: L. monocytogenes was isolated from 18/150 participants (12.0%; 95% CI, 7.3-18.1%), with the highest positivity among spontaneous abortion cases (14.3%). PCR detected hlyA, actA, and inlA in all 18 isolates and inlB in 12/18 (66.7%). The sequenced representative isolate A125-2 was assigned to Sequence Type 1 (ST1) and Clonal Complex 1 (CC1) and carried LIPI-1, LIPI-3, multiple internalin genes, stress-response determinants, and several antimicrobial-resistance-associated genes. WGS also detected inlB in A125-2 despite the PCR discrepancy. Descriptively, 28.7% of participants reported unpasteurized dairy exposure, and 61.1% of L. monocytogenes-positive cases occurred during winter.
CONCLUSION: The clinical and PCR findings support an association between L. monocytogenes and adverse pregnancy outcomes in this Iraqi cohort. Genomic characterization of one representative isolate demonstrated an ST1/CC1 background with multiple virulence and stress-adaptation determinants and illustrated the added resolution of WGS for investigating PCR discrepancies. Because only one isolate underwent WGS, the genomic findings should be interpreted as isolate-specific and not as population-level evidence for Iraqi L. monocytogenes strains. Broader multi-isolate genomic surveillance is warranted.