Expression of proteins involved in the adhesion of Listeria monocytogenes to mammalian cells or in the intracellular life cycle of this bacterium, including listeriolysin O (LLO),). Of the strains isolated from patients with non-pregnancy-related cases of listeriosis, bacteremia was predominantly associated with group Ami1 strains (OR ؍ 1.89; P ؍ 1 ؋ 10 ؊2 ) and central nervous system infections were associated with group ActA2 strains (OR ؍ 3.04; P ؍ 1 ؋ 10 ؊3 ) and group ActA3 strains (OR ؍ 3.91; P ؍ 1 ؋ 10 ؊3 ).Since the transmission of human listeriosis was first shown to be food borne in 1981, Listeria monocytogenes has been recognized as a major food-borne pathogen. The severity of listeriosis, which can cause abortions, bacteremia, and central nervous system infections (CNSI) and has a high mortality rate (20 to 30% [13,36]), makes it a serious public health problem. In addition, the fact that various foods have been implicated in outbreaks of listeriosis (37) and the increase in product recalls (48) have led to serious economic problems associated with this bacterium.Based on present knowledge, any strain of L. monocytogenes should be considered potentially pathogenic for humans. Nevertheless, a number of observations suggests that L. monocytogenes virulence is heterogeneous. Serotyping has revealed that strains are heterogeneously distributed; most major outbreaks of listeriosis (37) have been caused by strains belonging to serovar 4b, which has also been responsible for numerous sporadic cases (13, 36). However, a low percentage of food samples is contaminated with strains of this serovar (1, 25). Analysis of surface proteins, sequencing of virulence genes, and PCR-restriction enzyme analysis of virulence genes have revealed that differences are connected to the origin or typing characteristics of the strains (34,38,43,49,50,51). The tests used to study L. monocytogenes pathogenicity include tissue culture assays and tests in which laboratory animals are used (5,7,9,44,46). These methods also have revealed heterogeneity in the virulence of strains. For example, counts of viable bacteria in spleens revealed that virulence levels varied from less than 10 3 to 10 8 CFU (5). However, there was no clear correlation between strain characteristics and the degree of virulence. Therefore, there are currently no laboratory tests which can predict the danger associated with L. monocytogenes strains.The mechanisms by which L. monocytogenes invades a host have been studied in detail (21). Listeriolysin O (LLO) is a 58-to 60-kDa secreted protein which allows the bacterium to escape from a phagocytosis vacuole (8, 15). LLO is a toxin which acts only on cholesterol-containing membranes in which cholesterol is considered the receptor. Nonhemolytic mutants are always avirulent in mice (15). However, the level of in vitro hemolysin production is not directly proportional to the virulence of a strain (18). InlB, which is a 67-kDa surface and secreted protein, is sufficient for entry of the bacterium into cells...