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Review
Identification, subtyping and virulence
determination of Listeria monocytogenes,
an important foodborne pathogen
Dongyou Liu
Correspondence
liu@cvm.msstate.edu
Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University,
PO Box 6100, MS 39762-6100, USA
Listeria monocytogenes is an opportunistic intracellular pathogen that has become an important
cause of human foodborne infections worldwide. Given its close relationship to other Listeria
species and its tendency to produce non-specific clinical symptoms, the availability of rapid,
sensitive and specific diagnostic tests for the differentiation of L. monocytogenes from other Listeria
species is helpful for selecting appropriate treatment regimens. In addition, with L. monocytogenes
comprising a diversity of strains of varying pathogenicity, the ability to precisely track the strains
involved in listeriosis outbreaks and speedily determine their pathogenic potential is critical for
the control and prevention of further occurrences of this deadly disease. Extensive research
in recent decades has revealed significant insights regarding the molecular mechanisms of
L. monocytogenes infection. This in turn has facilitated the development of laboratory procedures
for enhanced detection and identification of L. monocytogenes, and has also contributed to the
implementation of improved control and prevention strategies against listeriosis. The purpose of
this review is to summarize recent progress in the species-specific identification, subtyping and
virulence determination of L. monocytogenes strains, and to discuss future research needs
pertaining to these important areas of listeriosis.
Introduction
The genus Listeria represents a group of closely related,
Gram-positive, facultative anaerobic, non-spore-forming,
rod-shaped bacteria 0?5
mm in width and 1–1?5 mmin
length, and with a low G+C content. Taxonomically, it is
divided into six species (i.e. Listeria monocytogenes, Listeria
ivanovii, Listeria seeligeri, Listeria innocua, Listeria welshi-
meri and Listeria grayi), of which only L. monocytogenes
and L. ivanovii are pathogenic (Robinson et al., 2000). While
L. monocytogenes infects both man and animals, L. ivano vii
(previously known as L. monocytogenes serotype 5) is princi-
pally an animal pathogen that rarely occurs in man (Low &
Donachie, 1997). Being tolerant to extreme pH, temperature
and salt conditions (Sleator et al., 2003; Liu et al., 2005a),
Listeria species are present in a variety of environments,
including soil, water, effluents and foods. With manufac-
tured ready-to-eat foods being consumed in increasing
quantities, it is no surprise that L. monocytogenes has become
recognized as an important opportunistic human food-
borne pathogen.
Although L. monocytogenes is infective to all human popula-
tion groups, it has a propensity to cause especially severe
problems in pregnant women, neonates, the elderly, and
immunosuppressed individuals. During the early stages
of infection, human listeriosis often displays non-specific
flu-like symptoms (e.g. chills, fatigue, headache, and
muscular and joint pain) and gastroenteritis. However,
without appropriate antibiotic treatment, it can develop
into septicaemia, meningitis, encephalitis, abortion and,
in some cases, death (Vazquez-Boland et al., 2001). Indeed,
with mortality rates on average approaching 30 %, L. mono-
cytogenes far exceeds other common foodborne pathogens,
such as Salmonella enteritidis (with a mortality of 0?38 %),
Campylobacter species (0?02–0?1 %) and Vibrio species
(0?005–0?01 %) in terms of disease severity (Altekruse
et al., 1997; Mead et al., 1999).
Given the close morphological and biochemical resem-
blances of L. monocytogenes to other Listeria species, and the
non-specific clinical manifestations of listeriosis (Vazquez-
Boland et al., 2001), the availability of rapid, specific and
sensitive diagnostic tests capable of distinguishing L. mono-
cytogenes from other Listeria species is essential for the
effective control of the disease. In addition, with L. mono-
cytogenes comprising a diversity of strains (Kathariou,
2002), the development of subtyping procedures is critical
to the epidemiologic investigation of listeriosis outbreaks.
Furthermore, since L. monocytogenes demonstrates strain
variations in virulence and pathogenicity (Liu et al., 2003a;
Roche et al., 2003), the ability to determine accurately and
rapidly the pathogenic potential of L. monocytogenes isolates
is essential to limit the spread of listeriosis and reduce
unnecessary recalls of food products.
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2006 SGM Printed in Great Britain 645
Journal of Medical Microbiology (2006), 55, 645–659 DOI 10.1099/jmm.0.46495-0
Extensive research in recent decades has led to significant
insights regarding Listeria species and listeriosis (Vazquez-
Boland et al., 2001). The establishment of animal models
and in vitro cell culture systems for listeriosis has helped the
delineation of key stages in L. monocytogenes infection and
pathogenesis. The application of molecular techniques has
facilitated the identification and characterization of major
virulence-associated genes and proteins in L. monocytogenes.
The development of serological and nucleic-acid-based
detection procedures has enhanced the laboratory detection
and differentiation of Listeria species. Since in-depth reviews
on the epidemiology, pathogenesis and virulence determi-
nants of L. monocytogenes are available (Low & Donachie,
1997; Vazquez-Boland et al., 2001; Kathariou, 2002), this
communication focuses on recent progress in the species-
specific identification, subtyping and virulence determina-
tion of L. monocytogenes, and discusses future research needs
in these areas.
Molecular characteristics
L. monocytogenes is a remarkable bacterium that has evolved
over a long period to acquire a diverse collection of molec-
ules, each with unique properties and functions, and each
contributing to the success of L. monocytogenes as an intra-
cellular pathogen. Upon ingestion by the host via con-
taminated food, L. monocytogenes withstands exposure to
host proteolytic enzymes, the acidic stomach environment
(pH 2?0), bile salts and non-specific inflammatory attacks,
largely through the actions of several stress-response genes
(opuCA, lmo1421 and bsh) and related proteins (Sleator
et al., 2003).
Having survived this initial stage, L. monocytogenes adheres
to and is internalized by host cells with the assistance of a
family of surface proteins called internalins (Gaillard et al.,
1991). The most notable internalins are InlA and InlB.
Whereas InlA (an 88 kDa protein encoded by inlA) interacts
with E-cadherin to mediate L. monocytogenes entry into
epithelial cells, InlB (a 65 kDa protein encoded by inlB)
recognizes C1q-R (or Met) to facilitate L. monocytogenes
entry into a much broader range of host-cell types, including
hepatocytes, fibroblasts and epithelioid cells. Gaining entry
to host cells enables L. monocytogenes to evade host immune
surveillance functions (Vazquez-Boland et al., 2001).
Following its uptake by host cells, L. monocytogenes is pri-
marily located in single-membraned vacuoles. Two virulence-
associated molecules are responsible for lysis of the primary
single-membraned vacuoles and subsequent escape by L.
monocytogenes: listeriolysin O (LLO) and phosphatidyl-
inositol-phospholipase C (PI-PLC). LLO (a 58 kDa protein
encoded by hly) is a pore-forming, thiol-activated toxin that
is essential for L. monocytogenes virulence (Portnoy et al.,
1992). PI-PLC (a 33 kDa protein encoded by plcA), acting
in synergy with phosphatidylcholine-phospholipase C (PC-
PLC, a 29 kDa protein encoded by plcB), aids LLO in lysing
the primary vacuoles (Vazquez-Boland et al., 2001).
After lysis of the primary single-membraned vacuoles, L.
monocytogenes is released to the cytosol, where it undergoes
intracellular growth and multiplication. The intracellular
mobility and cell-to-cell spread of L. monocytogenes require
another surface protein, ActA (a 67 kDa protein encoded by
actA), which is cotranscribed with PC-PLC and mediates the
formation of polarized actin tails that propel the bacteria
toward the cytoplasmic membrane. At the membrane, bac-
teria become enveloped in filopodium-like structures that
are recognized and engulfed by adjacent cells, resulting in
the formation of secondary double-membraned vacuoles.
A successful lysis of the secondary double-membraned
vacuoles signals the beginning of a new infection cycle,
which is dependent on PC-PLC upon activation by Mpl (a
60 kDa metalloprotease encoded by mpl) (Vazquez-Boland
et al., 2001).
The genes encoding the virulence-associated proteins PI-
PLC, LLO, Mpl, ActA and PC-PLC are located in a 9?6kb
virulence gene cluster (Gouin et al., 1994), which is prin-
cipally regulated by a pleiotropic virulence regulator, PrfA (a
27 kDa protein encoded by prfA). The prfA gene is situated
immediately downstream of, and sometimes cotranscribed
with, the plcA gene. PrfA activates the transcription of many
L. monocytogenes virulence-associated genes. The genes
encoding InlA and InlB are positioned elsewhere in the
genome. As the inlA and inlB genes possess a transcription
binding site similar to that recognized by PrfA, they may also
be partially regulated by PrfA. In addition to these virulence-
associated genes and proteins, several other genes, such as
iap (encoding
invasion-associated protein, or Iap), are also
involved in L. monocytogenes virulence and pathogenicity
(Vazquez-Boland et al., 2001).
Species-specific identification
As L. monocytogenes is morphologically indistinguishable
from other Listeria species, and often causes non-specific
clinical symptoms, laboratory testing is required to differ-
entiate L. monocytogenes from other Listeria species, and to
diagnose listeriosis. The confirmation of Listeria species
identity has clinical relevance, that is, the absence of L.
monocytogenes in clinical specimens may render antibiotic
therapy unnecessary, unless immunocompromised patients
are involved. The earlier diagnostic methods for L. mono-
cytogenes are largely phenotype-based, and characterize the
gene products of L. monocytogenes through the measure-
ment of biochemical, antigenic and bacteriophage pro-
perties. Since these properties may vary with changing
external conditions, with growth phase and with sponta-
neous genetic mutations, the use of phenotypic tests may
sometimes lead to equivocal results. Following recent
advances in molecular genetic techniques, methods target-
ing unique genes in Listeria have been designed for the
specific differentiation of L. monocytogenes from other
Listeria species; these methods are intrinsically more
precise and less affected by natural variation than the
phenotypic methods.
646 Journal of Medical Microbiology 55
D. Liu
Biochemical methods
Listeria species are closely related bacteria that share many
morphological and biochemical characteristics. Apart from
being catalase positive, and indole and oxidase negative,
Listeria species can hydrolyse aesculin, but not urea. These
common biochemical features have frequently been
exploited for the differentiation of Listeria species from
other bacteria. On the other hand, Listeria species also
possess distinct biochemical properties that can be useful for
species-specific identification. For instance, Listeria species
show significant variations in their ability to haemolyse
horse or sheep red blood cells, and in their ability to produce
acid from
L-rhamnose, D-xylose and a-methyl-D-mannoside
(Robinson et al., 2000).
Hence, L. ivanovii is differentiated biochemically from L.
monocytogenes and other Listeria species by its production of
a wide, clear or double zone of haemolysis on sheep or horse
blood agar, a positive Christie–Atkins–Munch-Petersen
(CAMP) reaction with Rhodococcus equi but not with
haemolytic Staphylococcus aureus, and fermentation of
D-xylose but not L-rhamnose (Rocourt & Catimel, 1985).
In addition, L. ivanovii is distinguished from L. monocyto-
genes by its strong lecithinase reaction with or without
charcoal in the medium, in comparison to L. monocyto-
genes, which requires charcoal for its lecithinase reaction
(Ermolaeva et al., 2003). Similarly, L. innocua is distin-
guished from L. monocytogenes on the basis of its negative
CAMP reaction and its failure to cause
b-haemolysis or to
show PI-PLC activity on chromogenic media. L. welshimeri
is differentiated from other Listeria species by its negative
b-haemolysis and CAMP reactions, and by its acid produc-
tion from
D-xylose and a-methyl-D-mannoside (Robinson
et al., 2000).
Nevertheless, the identification of Listeria species by bio-
chemical methods is a laborious process, involving primary
isolation with selective and enrichment media, followed by
Gram stain and multiple biochemical tests. For the isolation
of Listeria that has been injured during food processing,
a pre-enrichment in phosphate-buffered broth medium
containing inhibitors is also needed. The incorporation of
various biochemical procedures into a single testing plat-
form has streamlined the diagnostic process for Listeria
species (Rocourt & Catimel, 1985; Bille et al., 1992). How-
ever, biochemical testing of Listeria species remains time-
consuming (taking up to 6 days to finalize a result) and
costly. Furthermore, as biochemical tests measure the
phenotypic characteristics of Listeria bacteria, their perfor-
mance can be influenced by external factors that affect
bacterial growth and metabolic mechanisms.
Serological methods
Listeria species possess group-specific surface proteins,
such as somatic (O) and flagellar (H) antigens that are
useful targets for serological detection with corresponding
monoclonal and polyclonal antibodies. While there are 15
Listeria somatic (O) antigen subtypes (I–XV), flagellar (H)
antigens comprise four subtypes (A–D) (Seeliger & Ho
¨
hne,
1979; Seeliger & Jones, 1986), with the serotypes of indivi-
dual Listeria strains being determined by their unique
combinations of O and H antigens (Table 1). Through
examination of group-specific Listeria O and H antigens in
slide agglutination, at least 12 serotypes (i.e. 1/2a, 1/2b, 1/2c,
3a, 3b, 3c, 4a, 4b, 4c, 4d, 4e and 7) have been recognized in L.
monocytogenes, several (e.g. 1/2a, 1/2b, 3b, 4a, 4b, 4c and 6b)
in L. seeligeri, one (i.e. 5) in L. ivanovii, and a few (e.g. 1/2b,
6a and 6b) in L. innocua, L. welshimeri and L. grayi (Seeliger
& Jones, 1986; Kathariou, 2002). Since slide agglutination is
not easily adapted for high-throughput testing, an ELISA
has recently been developed to improve efficiency (Palumbo
et al., 2003).
Besides their value for the differentiation of Listeria species,
serotyping methods are also potentially useful for defining
subtypes and clonal groups of L. monocytogenes. Indeed, it
has been observed that L. monocytogenes serotypes 1/2a, 1/2b
and 4b are responsible for 98 % of documented human
listeriosis cases, whereas serotypes 4a and 4c are rarely
associated with outbreaks of the disease (Wiedmann et al.,
1996; Jacquet et al., 2002). Furthermore, while L. monocyto-
genes serotype 4b strains are isolated mostly from epidemic
outbreaks of listeriosis, serotypes 1/2a and 1/2b are linked
to sporadic L. monocytogenes infection (Wiedmann et al.,
1996). On a note of veterinary relevance, L. monocytogenes
isolates from sheep encephalitis are usually of serotypes
1/2b or 4b, and those from septicaemia and abortion cases
are predominantly of serotype 1/2a (Low & Donachie,
1997).
However, due mainly to the high cost of acquiring subtype-
specific antisera, serotyping methods are not routinely
Table 1. Compositions of somatic (O) and flagellar (H)
antigens in Listeria serotypes
Based on Seeliger & Jones (1986).
Serotype O antigens H antigens
1/2a I, II A, B
1/2b I, II A, B, C
1/2c I, II B, D
3a II, IV A, B
3b II, IV A, B, C
3c II, IV B, D
4a (V), VII, IX A, B, C
4b V, VI A, B, C
4c V, VII A, B, C
4d (V), VI, VIII A, B, C
4e V, VI, (VIII), (IX) A, B, C
7 XII, XIII A, B, C
5 (V), VI, (VIII), X A, B, C
6a V, (VI), (VII), (IX), XV A, B, C
6b (V), (VI), (VII), IX, X, XI A, B, C
http://jmm.sgmjournals.org 647
Identification of Listeria monocytogenes
performed in clinical laboratories. With both L. monocyto-
genes and L. seeligeri containing serotypes 1/2a, 1/2b, 3b,
4a, 4b, 4c and 6b, the inability of serotyping methods to
correlate serotypes directly with species identities further
limits their potential for widespread clinical application.
Moreover, as antigen sharing occurs frequently among
various L. monocytogenes serotypes, with 1/2a and 3c both
containing H antigens A and B; 4a–d, 1/2b and 3b all having
H antigens A, B and C; 1/2c and 3a both possessing H
antigens B and D; and multiple, common O antigens being
present in different serotypes (Table 1), it can be a challenge
to conclusively determine the serotype of some L. monocyto-
genes strains (Schonberg et al., 1996; Liu et al., 2006a). Like
biochemical methods, serotyping methods are also liable to
give occasional discrepant results because of their depend-
ence on the phenotypic characteristics of Listeria bacteria.
For these reasons, serotyping methods have largely been
superseded by molecular procedures that are intrinsically
more specific and sensitive for the identification and differ-
entiation of Listeria species.
Molecular methods
Detection by gene probes.
A gene probe is a stretch of
specific single-stranded nucleic acid that is enzyme- or
radiolabelled and employed for the identification and
detection of a (usually membrane-bound) complementary
nucleic acid sequence in a target organism. Being a first-
generation nucleic acid detection technology, the detec-
tion of L. monocytogenes by gene probes is precise and
relatively straightforward. Listeria DNA is spotted onto a
supporting matrix (e.g. a nitrocellulose filter or nylon
membrane), hybridized with an enzyme- or radiolabelled
Listeria species-specific gene probe (derived from 16S
rRNA, heat-shock protein P60 or other protein-coding
gene), and subsequently detected with an appropriate sub-
strate (enzyme label) or by autoradiography (radiolabel)
(Klinger et al.,1988;Kohleret al., 1990). As this procedure
exploits differences among Listeria species at the genetic
level, it is more specific than biochemical and serological
methods that are phenotype based. However, since it does
not involve nucleic acid amplification, this technique has
limited sensitivity, requiring at least 10
4
copies of target
gene per microlitre for reliable detection without signal
amplification, although improving to as few as 500 copies
of target gene per microlitre with signal amplification; this
is inadequate for most clinical samples. Since the intro-
duction of nucleic acid amplification technology, the
employment of gene-probe-based detection procedures
has steadily declined.
Detection by nucleic acid amplification. In vitro amplifi-
cation of nucleic acid is a more recent addition to the
genetic detection methods for pathogen identification and
diagnosis. Among several elegant approaches to nucleic
acid amplification, PCR was the first and remains the most
widely applied technique in both research and clinical
laboratories. PCR employs two primers (usually 20–30
nucleotides long) that flank the beginning and end of a
specific DNA target, a thermostable DNA polymerase that
is capable of synthesizing the specific DNA, and double-
stranded DNA to function as a template for DNA poly-
merase. The PCR process begins at a high temperature
(e.g. 94
u
C) to denature and open the double-stranded
DNA template into single-stranded DNA, followed by a
relatively low temperature (e.g. 54
u
C) to enable anneal-
ing between the single-stranded primer and the single-
stranded template, and then a temperature of 72
u
Cto
allow DNA polymerase copying (extension) of the template.
The whole process is repeated 25–30 times so that a single
copy of DNA template can turn into billions of copies
within 3–4 h. As PCR has the ability to selectively amplify
specific targets present in low concentrations (theoretically
down to a single copy of DNA template), it offers exquisite
specificity, unsurpassed sensitivity, rapid turnover, and
ease of automation for laboratory detection of L. monocyto-
genes from clinical specimens, in addition to its value for
identifying both cultured and non-cultivable organisms.
The amplified DNA products can be separated by agarose
gel electrophoresis and detected with a DNA stain, or
alternatively detected via labelled probes, DNA sequenc-
ing, microarray and other related techniques (Wang et al.,
1993; Manzano et al., 2000; Volokhov et al., 2002). By
exploiting molecular differences within 16S and 23S rRNA
genes, intergenic spacer regions, hly, inlA, inlB, iap and
other genes (e.g. delayed-type hypersensitivity gene, amino-
peptidase gene and putative transcriptional regulator gene
lmo0733), L. monocytogenes is rapidly and precisely differ-
entiated from other Listeria species and common bacteria
(Table 2) (Aznar & Alarcon, 2002).
The application of a multiplex PCR assay to selectively
amplify a shared iap gene facilitates the differentiation of
all six Listeria species in a single test (Bubert et al., 1999).
However, with assays relying on the selective amplifica-
tion of a shared gene, extreme care is required to ascertain
the sizes of the amplified products, which may show minute
size differences among various Listeria species. For this
reason, targeting Listeria genes unique to individual species
is beneficial, as it provides an independent means of
confirming the species identities (Gilot & Content, 2002;
Liu et al., 2003b, 2004b, 2004c, 2004d, 2005b). In cases
where the co-presence of several Listeria species complicates
the identification of L. monocytogenes, the availability of
PCR assays for unique species-specific genes is desirable to
help clarify the issue. The development of PCR-based
serotyping procedures, such as the use of group-specific
PCR primers, has provided additional tools for the identifi-
cation and grouping of L. monocy togenes (Jinneman & Hill,
2001; Borucki & Call, 2003; Doumith et al., 2004a). The
adaptation of conventional PCR to the reverse transcrip-
tion PCR (RT-PCR) format also permits the detection of
viable L. monocytogenes organisms in specimens. Finally, by
coupling PCR to the DNA sequencing analysis of Listeria
16S rRNA genes, it has been possible to further enhance
the genetic speciation and phylogenetic study of Listeria
bacteria.
648 Journal of Medical Microbiology 55
D. Liu
Table 2. Identification of Listeria species by PCR-based procedures
Species Target gene Protein Reference
L. monocytogenes 16S rRNA gene Wang et al. (1992); Manzano et al. (2000)
23S rRNA gene Sallen et al. (1996); Paillard et al. (2003)
16S/23S rRNA intergenic
regions
Graham et al. (1996, 1997)
hly LLO Furrer et al. (1991); Blais et al. (1997)
plcA PI-PLC Volokhov et al. (2002)
plcB PC-PLC Volokhov et al. (2002)
actA ActA Longhi et al. (2003)
prfA Transcriptional regulator PrfA Wernars et al. (1992)
inlA Internalin A Poyart et al. (1996); Jung et al. (2003)
inlB Internalin B Pangallo et al. (2001); Jung et al. (2003)
iap Invasion associated protein Bubert et al. (1992, 1999)
lma/dth18 LmA antigen/delayed-type
hypersensitivity protein
Johnson et al. (1992)
fbp Fibronectin-binding protein Gilot & Content (2002)
flaA Flagellin A Gray & Kroll (1995)
pepC Aminopeptidase C Winters et al. (1999)
clpE Clp ATPase Volokhov et al. (2002)
lmo0733 Putative transcriptional
regulator
Liu et al. (2004a)
L. ivanovii 16S rRNA gene Wang et al. (1993); Sallen et al. (1996);
Manzano et al. (2000)
23S rRNA gene Sallen et al. (1996); Paillard et al. (2003)
16S/23S rRNA intergenic
regions
Graham et al. (1997)
iap
Invasion associated protein Bubert et al. (1992, 1999)
liv22-228 Putative N-acetylmuramidase Liu et al. (2004c)
L. seeligeri 16S rRNA gene Sallen et al. (1996); Manzano et al. (2000)
23S rRNA gene Sallen et al. (1996); Paillard et al. (2003)
16S/23S rRNA intergenic
regions
Graham et al. (1997)
iap Invasion associated protein Bubert et al. (1992, 1999)
lse24-315 Putative internalin Liu et al. (2004d)
L. innocua 16S rRNA gene Manzano et al. (2000)
23S rRNA gene Sallen et al. (1996); Paillard et al. (2003)
16S/23S rRNA intergenic
regions
Graham et al. (1997)
iap Invasion associated protein Bubert et al. (1992, 1999)
lin0464 Putative transcriptional regulator Liu et al. (2003a)
lin2483 Putative transporter Rodrı
´
guez-La
´
zaro et al. (2004)
L. welshimeri 16S rRNA gene Sallen et al. (1996); Manzano et al. (2000)
23S rRNA gene Paillard et al. (2003)
16S/23S rRNA intergenic
regions
Graham et al. (1997)
fbp Fibronectin-binding protein Gilot & Content (2002)
iap Invasion associated protein Bubert et al. (1992, 1999)
lwe7-571 Putative phosphotransferase
system enzyme IIBC
Liu et al. (2004b)
L. grayi 16S rRNA gene Sallen et al. (1996); Manzano et al. (2000)
23S rRNA gene Paillard et al. (2003)
16S/23S rRNA intergenic
regions
Graham
et al. (1997)
iap Invasion associated protein Bubert et al. (1992, 1999)
lgr20-246 Putative oxidoreductase Liu et al. (2005b)
http://jmm.sgmjournals.org 649
Identification of Listeria monocytogenes
Subtyping
With L. monocytogenes consisting of a diversity of strains,
the availability of subtyping procedures to track individual
strains involved in listeriosis outbreaks, and to examine the
epidemiology and population genetics of L. monocytogenes
bacteria, is integral to control and prevention programmes
aimed at listeriosis. Similar to species-specific identifica-
tion, two major subtyping approaches are in common use:
phenotypic and genetic (molecular or DNA) subtyping. The
phenotypic subtyping approach includes serotyping, phage
typing, multilocus enzyme electrophoresis (MLEE) and
esterase typing. The genetic subtyping approach encom-
passes pulsed-field gel electrophoresis (PFGE), ribotyping,
PCR-based subtyping techniques [e.g. random amplification
of polymorphic DNA (RAPD), amplified fragment length
polymorphism (AFLP), PCR-restriction fragment length
polymorphism (PCR-RFLP) and repetitive element PCR
(REP-PCR)] and DNA sequencing-based subtyping techni-
ques [e.g. multilocus sequence typing (MLST)]. While the
phenotypic subtyping approach occasionally suffers from
low discrimination and reproducibility, the genetic sub-
typing approach is highly sensitive, discriminatory and
reproducible. For improved subtyping discrimination, a
combination of two or more subtyping techniques, be they
gene or phenotype based, is often used in practice for
epidemiologic investigation of L. monocytogenes outbreaks.
Phenotypic subtyping methods
Serotyping.
By separating L. monocytogenes strains into
12 serotypes (i.e. 1/2a, 1/2b, 1/2c, 3a, 3b, 3c, 4a, 4b, 4c, 4d,
4e and 7) on the basis of serological reactions between
somatic (O)/flagellar (H) antigens and their correspond-
ing antisera (Table 1) (Seeliger & Ho
¨
hne, 1979; Seeliger &
Jones, 1986), serotyping may potentially be useful for
tracking L. monocytogenes strains involved in disease out-
breaks. Given that only three serotypes (1/2a, 1/2b and
4b) are commonly associated with human listeriosis, how-
ever, the value of serotyping in L. monocytogenes epidemi-
ological investigations is somewhat limited. In addition,
the inability of the serotyping procedures to give a fine
distinction among serotypes 4a, 4b and 4c has further
hampered their potential utility (Liu et al., 2006a). In fact,
whereas four serotype 4b strains belonging to lineage I
strains as evaluated by prfA virulence gene cluster sequences
reacted in PCR with serotypes 4b-, 4d- and 4c-specific
ORF2110 virulence-specific lmo1134 and lmo2821 primers,
all nine serotype 4b strains belonging to lineage III strains
were negative by ORF2110 and lmo1134 primers (Ward
et al., 2004). Based on their differential reactions in PCR
and Southern blot, the four serotype 4b lineage I strains
are unquestionably of serotype 4b; however, seven of the
nine serotype 4b lineage III strains appear to be of sero-
type 4c and the other two of serotype 4a (Liu et al.,
2006a). Therefore, the serotyping procedure often plays
an accessory role in the subtyping and tracking of L.
monocytogenes epidemic strains.
Phage typing. Bacteriophages are viruses that occur
naturally in Listeria and other bacteria. Being host speci-
fic, bacteriophages have the capacity to lyse closely related
Listeria bacteria independently of the bacterial species and
serovar identities. Through examination of bacteriophage-
induced, host-specific lysis of Listeria bacteria on agar
plates, Listeria strains can be separated into distinct phage
groups and phagovars, which are useful for tracking the
origin and course of listeriosis outbreaks (Audurier et al.,
1984). In a phage-typing study involving 16 selected
phages, 57 Listeria reference strains and 454 food isolates,
Listeria strains were classified into four phage groups,
which in turn were divided into 41 distinct phagovars. On
the basis of a Listeria strain being lysed by at least one
phage at a 1006 routine test dilution, an overall typabil-
ity of 84?5 % was obtained (Loessner & Busse, 1990). By
increasing the number of bacteriophages to 21, a typabil-
ity of 89?5 % was noted after analysis of 1087 Listeria
strains (Loessner, 1991). Nonetheless, with close to 10 %
of Lis teria strains being untypable (especially serovar 3
and L. grayi strains), the usefulness of phage typing as
an independent tool for epidemiological investigations is
severely constrained.
MLEE. MLEE is a protein-based, isoenzyme typing method
that correlates specific protein band patterns with genotypes.
For this method, soluble proteins (or bacterial lysates) from
L. monocytogenes strains are separated by starch gel electro-
phoresis, polyacrylamide gel electrophoresis (PAGE), or iso-
electrophoretic focusing under native conditions, followed
by visualization with specific enzyme stains. Variations in
the electrophoretic mobility of different enzymes (or
electrophoretic types, ETs) enable differentiation of L.
monocytogenes strains. Since multiple enzymes are present
in L. monocytogenes, numerous ETs are often obtained. For
instance, assessment of 305 L. monocytogenes strains by
MLEE resulted in the detection of 78 ETs (Graves et al.,
1994). Based on the similar ETs detected in MLEE, L.
monocytogenes serovars 1/2b, 3b and 4b are classified into
one distinct division, and serovars 1/2a, 1/2c and 3a in
another division (Bibb et al., 1989; Piffaretti et al., 1989).
The detection of a large number of electrophoretic types
in L. monocytogenes strains by MLEE necessitates careful
optimization and standardization of the test procedure so
that run-to-run variations are minimized.
Esterase typing. Esterases are a class of heat-stable
enzymes that hydrolyse carboxylic acid esters. Being a
variant of MLEE analysis, esterase typing measures the
esterase activity from cell extracts of individual L. mono-
cytogenes strains on starch gels following electrophoresis.
Upon examination by esterase typing of 219 L. monocyto-
genes isolates from milk, non-dairy foods, and clinical and
veterinary sources, Harvey & Gilmour (1996) detected 59
ETs. Like MLEE, esterase typing produces a high number
of ETs that require careful documentation and standardi-
zation. Furthermore, as a phenotype-based procedure, the
reproducibility of esterase typing is sometimes low.
650 Journal of Medical Microbiology 55
D. Liu
Genetic subtyping methods
PFGE.
PFGE is a highly reproducible, discriminatory and
effective molecular typing method that is based on restric-
tion fragment length polymorphisms (RFLPs) of bacterial
DNA. In RFLP analysis, bacterial genomic DNA is digested
with restriction enzymes to yield hundreds of fragments,
which are then separated by conventional agarose gel electro-
phoresis to form distinctive banding patterns for indivi-
dual strains. Given its complex band patterns, however,
the interpretation of RFLP results is notably tedious and
technically demanding. PFGE uses selected restriction
enzymes to yield between 8 and 25 large DNA bands of
40–600 kb in size, and alternating currents to cause DNA
fragments to move back and forth, resulting in a higher
level of fragment resolution. For this method, L. monocy-
togenes bacteria are first placed in agarose plugs, where
they are lysed, and the DNA is then digested with selected
restriction enzymes. The plugs containing the digested DNA
are transferred into an agarose gel and electrophoresed for
30–50 h with alternating currents. On the basis of distinct
DNA band patterns, PFGE classifies L. monocytogenes into
subtypes (or pulsotypes), providing sensitive subtype discri-
mination that is considered the reference standard (Brosch
et al., 1994, 1996; Graves et al., 1994). Indeed, after a com-
parative examination of 35 L. monocytogenes strains by
serotyping, esterase typing, ribotyping, RAPD and PFGE,
PFGE along with ribotyping produced the most discrimi-
natory outcomes for L. monocytogenes (Kerouanton et al.,
1998). However, due to its time-consuming nature (taking
30 h or longer to perform) and its requirement for special
equipment, PFGE is not widely used outside reference
laboratories.
Ribotyping. Ribotyping is a derivative of RFLP analysis
that uses a ribosomal DNA (rDNA) probe to detect the
restriction fragment patterns of chromosomal DNA
digested with appropriate restriction enzymes, resulting in
much simpler and more consistent band patterns. For this
method, Listeria DNA is initially digested with restriction
enzymes (e.g. EcoRI, PvuII and XhoI) into many pieces
(>300–500) of small-sized fragments (1–30 kb). The
resultant DNA fragments are then separated by agarose
gel electrophoresis, transferred to a membrane (via Southern
blot), and detected with a probe derived from the Escher-
ichia coli gene that encodes rRNA (rDNA). Thus, only
DNA fragments that contain rRNA genes are recognized
(Graves et al., 1994). In a study involving 1346 L. monocy-
togenes strains, Bruce et al. (1995) showed that 50 band
patterns can be detected after digestion of L. monocyto-
genes DNA with EcoRI and detection with the E. coli rrnB
rRNA operon.
On the whole, ribotyping is a robust, reproducible typing
technique that has a similar discriminatory power to, but
produces fewer bands than, PFGE. As ribotyping does not
demand special equipment, it has become a practical tool
that has been frequently employed for the tracking and
subtyping of L. monocytogenes bacteria. Indeed, with an
automated ribotyping test becoming available commer-
cially (RiboPrinter Microbial Characterization System,
Qualicon, Wilmington, DE), it is envisaged that ribotyping
will play an increasingly dominant role in the epidemiologic
investigation of disease due to L. monocytogenes.
PCR-based subtyping techniques
RAPD and arbitrarily primed PCR (AP-PCR).
Both RAPD
and AP-PCR use low-stringency PCR amplification with a
single primer of an arbitrary sequence to generate strain-
specific arrays of anonymous DNA fragments. For the
method, a single short random primer (usually 10 bases
long for AP-PCR, and 10–15 bases long for RAPD) is
used in PCR at a relatively low temperature (around 36
u
C)
to generate amplified products from L. monocytogenes
DNA that form distinct band patterns after agarose gel
electrophoresis. The possible mechanism behind RAPD
and AP-PCR is that by reducing the stringency of the
primer-annealing temperature, a random primer that
shows no complete homology to a genome may have a
perfect match of two to three nucleotides between the 39
end of the primer and the template strand to allow anneal-
ing and the priming of complementary strand synthesis by
DNA polymerase, given that a putative three-nucleotide
sequence can in principle be found once in each 64 nucleo-
tide sequence (4
3
permutations). When two such annealing
and priming events occur within a certain distance of each
other and in proper orientation, the sequence between the
matching sites can be amplified effectively. RAPD (or AP-
PCR) is more economical and faster than other typing
methods, and is particularly suitable for testing fewer than
50 strains. However, the discriminatory ability of RAPD
and AP-PCR is sometimes inconsistent (Farber & Addison,
1994; O’Donoghue et al., 1995). In a recent study, RAPD
gave less robust results than PCR ribotyping for subtyping
L. monocytogenes isolates involved in invasive and non-
invasive listeriosis outbreaks (Franciosa et al., 2001).
AFLP. AFLP is a modification of RFLP through the addition
of adaptors to restriction enzyme-digested DNA, followed
by PCR amplification and electrophoretic separation of
PCR products. In this procedure, L. monocytogenes DNA is
digested with two restriction enzymes, one with an aver-
age cutting frequency (e.g. EcoRI) and one with a higher
cutting frequency (e.g. Mse IorTaqI). The restriction frag-
ments are ligated with double-stranded oligonucleotide
adapters (i.e. linkers and indexers), and then amplified by
PCR with adapter-specific primers. The resultant PCR
products are separated by PAGE to generate highly infor-
mative, polymorphic patterns of 40–200 bands for indivi-
dual L. monocytogenes strains. Apart from differentiating
among the L. monocytogenes, L. innocua, L. ivanovii, L.
seeligeri, L. welshimeri and L. grayi species, AFLP is also
useful for separating L. monocytogenes strains into differ-
ent genotypes. Overall, AFLP is highly discriminatory,
sensitive and reproducible, thus representing a valuable
tool in the characterization of L. monocytogenes strains,
http://jmm.sgmjournals.org 651
Identification of Listeria monocytogenes
and also in the identification of Listeria species (Ripabelli
et al., 2000; Guerra et al., 2002; Keto-Timonen et al.,
2003). An obvious shortcoming of AFLP is its require-
ment for the ligation of linkers and indexers to enzyme-
digested DNA from individual strains, which apart from
being another time-consuming step, adds an extra dimen-
sion of uncertainty to the testing procedure.
PCR-RFLP. In contrast to AFLP, in which L. monocyto-
genes DNA is digested with restriction enzymes, linked
with adaptors to facilitate PCR amplification, PCR-RFLP
undertakes PCR amplification of one or more L. mono-
cytogenes housekeeping or virulence-associated genes (e.g.
hly, actA and inlA), followed by digestion with selected
restriction enzymes (e.g. HhaI, SacIorHinfI) and separa-
tion by agarose gel electrophoresis. Subsequent examina-
tion of the distinct band patterns permits differentiation
of L. monocytogenes subtypes (Wiedmann et al., 1997). As
it involves nucleic acid amplification, PCR-RFLP requires
only a small amount of starting DNA. It has the added
advantage over AFLP of obviating the need to ligate lin-
kers and indexers before PCR amplification. Used in com-
bination with other subtyping procedures, PCR-RFLP
provides a sensitive, discriminatory and reproducible
method for tracking and epidemiological investigation of
L. monocytogenes bacteria.
REP-PCR. Like other prokaryotic organisms, L. monocyto-
genes possesses a genome that contains randomly dispersed,
repetitive sequence elements, such as
repetitive extragenic
palindromes (REPs) of 35–40 bp with an inverted repeat,
and intergenic repeat units or
enterobacterial repetitive
intergenic consensus sequences (ERICs) of 124–147 bp with
a highly conserved central inverted repeat. The REP and
ERIC sequences represent useful primer binding sites for
PCR amplification of the L. monocytogenes genome to
achieve species and strain discrimination. Using REP-PCR,
L. monocytogenes strains have been divided into four clus-
ters that match the origin of isolation, each consisting of
multiple subtypes (Jersek et al., 1999). As it produces a
similar level of discrimination to PFGE and ribotyping
techniques, REP-PCR offers a valuable alternative for the
rapid subtyping of L. monocytogenes strains.
DNA sequencing-based subtyping techniques. DNA
sequencing of one or more selected genes is increasingly
used for genetic subtyping of L. monocytogenes. MLST
focuses on multiple genes or gene fragments (e.g. house-
keeping or virulence-associated genes) to determine the
subtypes and genetic relatedness of L. monocytogenes iso-
lates. The availability of DNA sequencing data also aids
the reconstruction of ancestral and evolutionary relation-
ships among L. monocytogenes isolates. Compared to other
typing methods, such as PFGE and ribotyping, MLST is
less ambiguous and easier to interpret (Ward et al., 2004).
With the cost of DNA sequencing decreasing rapidly,
MLST is poised to play a more important role in L. mono-
cytogenes subtyping and phylogenetic studies.
Although each of the subtyping procedures above represents
on its own an elegant approach to the tracking of L. mono-
cytogenes strains, the combined use of two or more pro-
cedures is generally more discriminatory and powerful than
each applied alone. In terms of technical simplicity and test
reliability, ribotyping and PCR-RFLP stand out clearly.
Indeed, by using ribotyping together with PCR-RFLP and
other subtyping procedures, L. monocytogenes strains have
been grouped into three genetic lineages (or divisions), with
lineage I consisting of serotypes 1/2b, 3b, 4b, 4d and 4e;
lineage II of serotypes 1/2a, 1/2c, 3a and 3c; and lineage III
of serotypes 4a and 4c (Rasmussen et al., 1995; Wiedmann
et al., 1997, 2002; Jeffers et al., 2001; Nadon et al., 2001; Gray
et al., 2004; Meinersmann et al., 2004). Interestingly, L.
monocytogenes isolates from sporadic and endemic human
listeriosis mostly belong to lineages I and II, whereas those
from animal and environmental specimens are of lineage III.
This information has been invaluable for tracking and
population genetic studies of L. monocytogenes strains
involved in disease outbreaks.
While a general consensus on the compositions and divi-
sions of lineages I and II exists, there is some uncertainty
concerning the make-up and taxonomic status of lineage III.
Within lineage III, three subsets (i.e. G8.1, H7.1; G5.8, H7.1;
and E/G5.8, H7.1) are delineated through Southern blot
analysis of EcoRI-digested L. monocytogenes DNA with a
probe from the rrnB rRNA operon of E. coli (Bruce et al.,
1995). In turn, the subset G8.1, H7.1 is subdivided into
seven ribotypes (dd0648, dd11903, dd8842, dd0652,
dd11696, dd11698 and dd12388) by ribotyping hly, inlA
and actA polymorphisms, with ribotype dd0648 being
represented by ATCC 19114 (Wiedmann et al., 1997). On
the other hand, while the subset G5.8, H7.1 comprises a
single ribotype, dd3823, the subset E/G5.8, H7.1 includes
two ribotypes, dd6821 and dd6824. Since the ribotype
dd0648 strain ATCC 19114 in the subset G8.1, H7.1
demonstrates only a 72 % DNA–DNA homology with the
L. monocytogenes type strain (barely above the 70 % DNA–
DNA relatedness required for the phylogenetic definition of
a species) and a 54 % homology with the L. innocua type
strain, it has been postulated that ATCC 19114 is a new
subspecies (Wiedmann et al., 1997). In addition, as strains in
the subsets G5.8, H7.1 and E/G5.8, H7.1 possessing inlA and
the G5.8 fragment are rhamnose negative, in contrast to the
L. monocytogenes type strain, which is rhamnose positive, the
existence of either two new subspecies or a new species has
been also hypothesized (Wiedmann et al., 1996, 1997).
After the recent examination of seven lineage III strains
from subsets G8.1, H7.1, G5.8, H7.1 and E/G5.8, H7.1, as
well as ribotypes DUP1061 and DUP10142, by using
PCR, Southern blot and DNA sequencing techniques,
the following have become apparent: (a) ribotype dd0648
strains (ATCC 19114 and FSL-J1-031) in the subset G8.1,
H7.1, and ribotype dd3823 strain (FSL-X1-008) in the
subset G5.8, H7.1, as well as ribotype DUP1061 strain
(FSL-J1-168), are clearly of L. monocytogenes serotypes 4a
652 Journal of Medical Microbiology 55
D. Liu
and 4c; (b) a close genetic relationship exists among three
serotype 4c strains of ribotype dd0648 (FSL-J1-031) in the
subset G8.1, H7.1, ribotype dd3823 (FSL-X1-008) in the
subset G5.8, H7.1 and ribotype DUP1061 (FSL-J1-168) in
comparison with the serotype 4a strain from ribotype
dd0648 (ATCC 19114) in the subset G8.1, H7.1; (c) being
rhamnose negative and possessing inlA, lmo2672 and
ORF2819, strains of ribotypes dd6821 (FSL-X1-009) and
dd6824 (FSL-X1-010) in the subset E/G5.8, H7.1 are likely of
serotype 7, which may represent a distinct genotype (or
subspecies) within the species of L. monocytogenes; and (d)
ribotype DUP10142 strain (FSL-J1-158), being related to
ribotypes dd3823 (subset G5.8, H7.1), dd6821 and dd6824
(subset E/G5.8, H7.1) through a shared reaction with lmo2672
primers, may constitute part of the genotype that encom-
passes ribotypes dd6821 and dd6824. Alternatively, because
of its negative reaction with ORF2819 primers, ribotype
DUP10142 strain (FSL-J1-158) may form another genotype
(or subspecies) distinct from the one that covers ribotypes
dd6821 and dd6824, which does not fit into the current
serotype scheme for L. monocytogenes (Liu et al., 2006b).
In addition, the transcriptional regulator lmo2672 gene (Liu
et al., 2004a) has also proven valuable as a target for the
specific identification of uncommon L. monocytogenes line-
age III strains [e.g. ribotypes dd6821 (FSL-X1-009), dd6824
(FSL-X1-010) and DUP10142 (FSL-J1-158)], as these strains
are undetected by the species-specific lmo0733 primers (Liu
et al., 2003a). Therefore, a combination of lmo0733 and
lmo2672 primers in a multiplex PCR format will facilitate
the detection of all L. monocytogenes strains, including the
rare lineage III isolates, in a rapid, sensitive and specific
manner (Liu et al., 2006b).
Virulence determination
Despite being pathogenic at the species level, L. mono-
cytogenes is in fact made up of a spectrum of strains or
genotypes with varying pathogenic potential. While many L.
monocytogenes strains are highly pathogenic and sometimes
deadly, others are relatively avirulent and cause little harm in
the host. The availability of laboratory methods to accur-
ately assess the pathogenic potential of L. monocytogenes
strains is therefore vitally important to the effective control
and prevention of listeriosis. Over the years, a variety of
methods have been developed to gauge the virulence of L.
monocytogenes strains. These include the mouse virulence
assay, in vitro cell assays, and the detection of virulence-
associated proteins and genes. These methods have not only
contributed to the improved understanding of L. mono-
cytogenes virulence and pathogenicity, but also helped devise
appropriate control measures against listeriosis.
Mouse virulence assay
The mouse virulence assay was one of the first methods
described for L. monocytogenes virulence assessment. Being
capable of providing an in vivo measurement of all virulent
determinants, the mouse virulence assay is regarded as the
gold standard for any newly developed tests for L. mono-
cytogenes virulence (Nishibori et al., 1995; Pine et al., 1991;
Roche et al., 2001; Liu et al., 2003a). In general, the mouse
virulence assay is conducted by inoculating groups of mice
with various doses of L. monocytogenes bacteria via the oral,
nasal, intraperitoneal, intravenous or subcutaneous routes.
The virulence of a given L. monocytogenes strain is deter-
mined by the mouse mortality resulting from infection,
after estimation of c.f.u. by plate counts, and is commonly
expressed as median lethal dose (LD
50
) (Reed & Muench,
1938; Welkos & O’Brien, 1994). Alternatively, the virulence
of a given L. monocytogenes strain can be determined by the
number of L. monocytogenes bacteria that reach the spleen
following experimental infection.
Although an essential step in LD
50
calculation, the estima-
tion of c.f.u. by plate counts is a task requiring considerable
attention and consistency, as it has a narrow margin of error.
The observation that L. monocytogenes strains with varying
levels of virulence often display vastly different growth rates
on many selective media further exacerbates the problem
(Gracieux et al., 2003). Even on a non-selective medium
(e.g. BHI agar), L. monocytogenes strains causing greater
mouse mortality tend to yield higher numbers of c.f.u. than
those causing less or no mouse mortality (Liu, 2004). Thus,
the number of c.f.u. for a given L. monocytogenes strain may
vary from run to run and from laboratory to laboratory,
resulting in different LD
50
values for an identical test strain.
Recently, relative virulence (%) has been described as an
alternative to LD
50
measurement for the practical and direct
interpretation of the mouse virulence assay for L. mono-
cytogenes (Liu, 2004). The relative virulence (%) is obtained
by dividing the number of dead mice by the total number of
mice tested for a particular strain, using a known virulent
strain (e.g. L. monocytogenes EGD) as reference. Being
independent of c.f.u. estimation, the relative virulence (%)
requires fewer dosage groups, and appears to give a more
accurate assessment of L. monocytogenes virulence. That is,
while the LD
50
values provide a somewhat imprecise mea-
sure of L. monocytogenes virulence, the relative virulence (%)
is much more direct and precise (Table 3). Nonetheless,
given the high cost associated with animal experimentation,
the mouse virulence assay is not routinely used for deter-
mining L. monocytogenes virulence.
In vitro cell assays
In vitro cell culture techniques have been explored as a low-
cost alternative to the mouse virulence assay for assessing
L. monocytogenes virulence. These methods measure the
ability of L. monocytogenes to cause cytopathogenic effects
in the enterocyte-like cell line Caco-2 (Pine et al., 1991), to
form plaques in the human adenocarcinoma cell line HT-29
(Roche et al., 2001), or to cause death in chicken embryos
(Olier et al., 2002). Several other cell lines (e.g. hepatocyte
Hep-G2, macrophage-like J774, epithelial Henle 407 and
L2) have also been employed in various protocols to
investigate L. monocytogenes ability to adhere, invade, escape
http://jmm.sgmjournals.org 653
Identification of Listeria monocytogenes
from vacuoles, grow intracellularly and spread to neigh-
bouring cells. In general, L. monocytogenes virulent strains
tend to produce more severe cytopathogenic damage in
Caco-2 cells, form more plaques with HT-29 cells and cause
higher mortality in chicken embryos than avirulent strains.
Furthermore, virulent strains are more capable of adhering
and entering Caco-2 and other cells, and they are also more
efficient in escaping from vacuoles, undergoing intracellular
growth, and spreading to neighbouring cells. As a result, the
pathogenic potential of L. monocytogenes can be evaluated
without expensive animal experimentation. The main advan-
tages of in vitro cell assays include their relatively low cost
and ease of use. However, these tests often suffer from the
drawbacks of being time-consuming, and occasionally var-
iable (especially with isolates whose virulence lies between
the virulent and avirulent extremes), which have prevented
them from being adopted in clinical laboratories for
determining L. monocytogenes virulence and pathogenic
potential.
Detection of virulence-associated proteins and genes
Early attempts to determine L. monocytogenes virulence
through the detection of virulence-associated proteins and
genes were largely unsuccessful, since many of the target
proteins and genes are present in both virulent and avirulent
strains. While in vitro demonstration of LLO, PC-PLC and
PI-PLC activities often provides general guidance on the
pathogenic potential of L. monocytogenes strains, its relia-
bility as a virulence indicator is by no means satisfactory.
Indeed, the association between haemolytic, PC-PLC and
PI-PLC activities and in vitro virulence has not been con-
vincingly established (Roche et al., 2001; Olier et al., 2002).
Similarly, PCR detection of L. monocytogenes virulence-
associated genes, such as inlA, inlB, actA , hly, plcA and plcB,
and genetic lineage analysis has not resulted in a clear
correlation between these genes and the underlying virul-
ence of L. monocytogenes (Piffaretti et al., 1989; Nishibori
et al., 1995; Rasmussen et al., 1995; Wiedmann et al., 1997;
Jaradat et al., 2002). Although some naturally virulence-
attenuated L. monocytogenes strains (particularly those
isolated from human carrier cases) often contain mutations
in their prfA, hly, actA and inlA genes, resulting in the
expression of truncated or non-functional PrfA, LLO, ActA
and InlA proteins (Olier et al., 2002; Roberts et al., 2005;
Roche et al., 2005), targeting these gene mutations as a
means of determining L. monocytogenes virulence does not
constitute a sound option in practical terms. On the one
hand, a screening assay for genetic alterations in multiple
L. monocytogenes genes can be cumbersome and costly. On
the other hand, many L. monocytogenes isolates will not be
covered by the assay due to their lack of changes in the genes
targeted. Therefore, an optimal strategy for L. monocytogenes
virulence testing remains the detection of virulence-specific
gene(s) that are present only in virulent strains, but absent in
avirulent strains.
The recent completion of the whole genome sequences of
several L. monocytogenes and L. innocua strains (Glaser et al.,
2001; Nelson et al., 2004) has facilitated the identification of
Table 3. Relative virulence of L. monocytogenes serotypes
ND, Not done; +, positive; 2, negative.
Strain Source Serovar lmo2821 PCR* LD
50
D Relative virulence (%)d
ATCC 19112 Human 2 + 1?6610
9
30
ATCC 19114 Human 4a 2 1?9610
10
0
ATCC 19115 Human 4b + 6?0610
8
70
ATCC 19116 Chicken 4c + 2?6610
8
100
ATCC 19117 Sheep 4d + 8?8610
8
40
ATCC 19118 Chicken 4e + 7?8610
9
50
ATCC 15313§ Rabbit 1 +>1?2610
11
0
EGD (NCTC 7973) Guinea pig 1/2a +<1?1610
7
100
HCC8 Catfish brain 1 +<7?0610
8
70
HCC25 Catfish kidney 4a 2 3?5610
10
0
874 Cow brain 4c +<8?0610
7
100
1002 Pork sausage
ND + 5?2610
8
60
*PCR was performed by using virulence-specific primers derived from L. monocytogenes internalin gene lmo2821 (inlJ) (Liu et al., 2003a; Liu,
2004; Sabet et al., 2005).
DDetermined by mouse virulence assay (Liu, 2004).
dRelative virulence (%) is calculated by dividing the number of dead mice by the total number of mice tested for a particular strain, using
virulent strain EGD as reference (Liu, 2004).
§Originating from an infected rabbit, ATCC 15313 was initially haemolytic, but later became non-haemolytic and avirulent after successive
laboratory subculturing. Despite possessing intact lmo2821 and many other virulence-specific genes, ATCC 15313 harbours a mutation in its hly
gene (encoding LLO), rendering it avirulent in the mouse virulence assay.
654 Journal of Medical Microbiology 55
D. Liu
novel virulence-specific genes with potential for improved
determination of L. monocytogenes virulence and patho-
genicity (Liu et al., 2003a; Liu, 2004). Using PCR primers
derived from the genes encoding putative transcriptional
regulators (i.e. lmo0833, lmo1116, lmo1134 and lmo2672),
putative internalins (i.e. lmo2821 and lmo2470) and
unknown proteins (i.e. lmo0834 and lmo1188), L. monocyto-
genes virulent strains could be readily differentiated from
avirulent strains. In particular, PCR targeting the putative
internalin gene lmo2821 offers a rapid, sensitive and precise
means of distinguishing virulent from avirulent L. mono-
cytogenes strains (Table 3).
The virulence of L. monocytogenes as determined by PCR
has subsequently been confirmed by a mouse model.
Examination of the representative L. monocytogenes strains
by a mouse virulence assay indicates that being the only
serotype not recognized by lmo2821 primers, serotype 4a
strains (e.g. HCC23, HCC25 and ATCC 19114) are unable
to produce mouse mortality, and are thus truly non-
pathogenic, while other serotype strains are more or less
virulent (using relative virulence as a criterion) (Table 3)
(Liu et al., 2003a; Liu, 2004). For instance, L. monocytogenes
avirulent strains with a relative virulence of 0 % are negative
by PCR, whereas L. monocytogenes virulent strains with a
relative virulence of 30–100 % are positive by PCR targeting
lmo2821. Recently, lmo2821 has been confirmed to be a
novel internalin gene (inlJ) directly involved in L. monocyto-
genes virulence (Sabet et al., 2005). Being present in L. mono-
cytogenes strains/serotypes that are capable of causing human
listerial outbreaks and mouse mortality, but absent in
avirulent, non-pathogenic strains/serotypes (Doumith et al.,
2004b; Liu, 2004), lmo2821 (i.e. inlJ) represents the target
of choice for laboratory differentiation of virulent from
avirulent L. monocytogenes strains.
Future perspectives
Being an opportunistic intracellular pathogen capable of
surviving various food manufacturing processes, L. mono-
cytogenes has become recognized as a major cause of
human foodborne infection during recent decades. As a
consequence, a concerted research effort has been directed
toward an improved understanding of the L. monocytogenes
bacterium and its pathogenic mechanisms. This in turn
has facilitated the development of laboratory procedures
for enhanced identification, subtyping and virulence
determination of L. monocytogenes, and contributed to the
implementation of appropriate and effective control and
prevention strategies against listeriosis.
As one of the earlier techniques developed, serotyping is a
phenotype-based diagnostic technique that has made the
early success in the detection and subtyping of L. mono-
cytogenes possible. However, since serotyping measures
the phenotypic characteristics of L. monocytogenes
, it may
sometimes give variable results (Schonberg et al., 1996; Liu
et al., 2006a). Attempts have been made to design and apply
PCR-based procedures for serotyping purposes, but these
methods fall short of achieving serotype-specific determina-
tion of L. monocytogenes (Borucki & Call, 2003; Doumith
et al., 2004a). Therefore, an improved understanding of the
molecular mechanisms underlying the regulation of L.
monocytogenes somatic (O) and flagellar (H) proteins is
essential. Toward this goal, a novel L. monocytogenes sero-
type 4b-specific gene cassette (gltA–gltB) has been char-
acterized (Lei et al., 2001; Kathariou, 2002). Further research
on the genes encoding other serotype-specific antigens will
help illuminate the mechanisms behind the production
and regulation of L. monocytogenes serotype proteins, and
lead to the development of novel molecular tests for reliable
and precise determination of L. monocytogenes serotypes.
In addition, considering that three strains (FSL-X1-009,
FSL-X1-010 and FSL-J1-158) from ribotypes dd6821,
dd6824 and DUP10142, respectively, appear phenotypically
and genetically distinct from other members within the
species of L. monocytogenes, but are probably related to
serotype 7, further study is required to verify the taxonomic
status of these strains and serotype 7 strains (e.g. the
possibility of their being either one or two separate novel
subspecies).
The application of various genetic subtyping procedures
has resulted in the classification of L. monocytogenes strains
into three lineages. While L. monocytogenes isolates from
sporadic and endemic human listeriosis are often in lineage I
(comprising serotypes 1/2b, 3b, 4b, 4d and 4e) and lineage II
(containing serotypes 1/2a, 1/2c, 3a and 3c), those from
animal and environmental specimens are of lineage III
(consisting of serotypes 4c and 4a). However, in spite of
being in the same genetic lineage III, serotypes 4c and 4a
demonstrate marked differences in the mouse virulence
assay. That is, while serotype 4c strains (e.g. ATCC 19116
and 874) display a relative virulence equal to that of the
control virulent strain EGD (i.e. 100 %), serotype 4a strains
(e.g. ATCC 19114 and HCC25) show a relative virulence of
0 % (Table 3) (Liu, 2004). The fact that a negligible number
of serotype 4c isolates originate from human listeriosis cases
suggests the inability of serotype 4c strains to establish in
human hosts. As L. monocytogenes serotype 4c strains lack
many virulence-specific putative transcriptional regulator
genes in comparison with strains of other serotypes (with
the exception of serotype 4a) (Liu et al., 2003a), it is possible
that some key invasion-associated proteins are not pro-
duced by serotype 4c strains as a result. It appears that these
proteins may be required for L. monocytogenes passage
through the intestine and subsequent phases before the
establishment of infection. Further experimentation is
warranted to pinpoint the events at which L. monocytogenes
serotype 4c strains fail to complete the infection cycle. This
may involve characterization of the virulence-specific,
putative transcriptional regulator genes and their protein
products, as well as the identification of the genes controlled
by these transcriptional regulators.
The internalin gene lmo2821 (i.e. inlJ) appears to be an
excellent target for determining L. monocytogenes virulence,
http://jmm.sgmjournals.org 655
Identification of Listeria monocytogenes
as strains capable of causing mouse mortality invariably
harbour this gene (Table 3) (Liu et al., 2003a; Liu, 2004).
With InlJ playing a direct role in L. monocytogenes virulence
(Sabet et al., 2005), it is important to further examine the
regulation of lmo2821 (inlJ) through identification of its
possible regulator(s) and related proteins. In addition, while
past research has largely been directed to elucidating the
molecular mechanisms of L. monocytogenes virulence and
pathogenicity, relatively little has been undertaken with
regard to the inability of L. monocytogenes avirulent strains
to cause disease. Given that both virulent and avirulent L.
monocytogenes strains are equally resistant to acid (pH 3?0
or lower) (Liu et al., 2005a), it is likely that avirulent strains
are capable of surviving the acidic stomach environment
once ingested by hosts. Therefore, the inability of L. mono-
cytogenes avirulent strains to result in listeriosis is most
likely due to their failure to go through other key stages of
infection, such as internalization, escape from vacuoles,
intracellular growth and cell-to-cell spread. Extending our
research to this area may help provide a more comprehen-
sive picture of L. monocytogenes virulence.
Acknowledgements
This study was made possible with a grant from US Department of
Agriculture Agricultural Research Service (Agreement No. 58-6202-5-
083). The author is indebted to Drs M. L. Lawrence, A. J. Ainsworth
and F. W. Austin for their interest in and support of the Listeria
research project.
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Identification of Listeria monocytogenes
