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Listeria monocytogenes is a Gram-positive intracellular pathogen capable of causing severe disease in susceptible populations, including the elderly, pregnant women, people with HIV/AIDS, and persons receiving chemotherapy1. Infection in these populations is frequently the result of ingesting contaminated food products, and most infections are associated with large-scale food-borne outbreaks2,3. In humans and other mammals, L. monocytogenes is capable of translocating across the epithelial border of the small intestine, thereafter being transported to the liver4,5. Animal models suggest that ingested bacteria replicate within the intestinal villi and transit to the liver through the portal vein or spread via the mesenteric lymph nodes into the blood stream, leading to hematogenous dissemination to the liver and spleen6,7. In the liver and spleen, the bacterium is capable of mediating uptake into both professional phagocytes as well as resident parenchymal cells, and quickly establishes infections within these organs. As bacterial load increases, numerous bacteria are dispersed back into the blood, where they are capable of further colonizing susceptible tissues including the central nervous system and placenta (where present). Colonization of these sites precludes most common manifestations of listeriosis in humans, including meningitis, encephalitis, and fetal abortion2.
Selected subpopulations of L. monocytogenes have been recently shown to have an enhanced capacity to invade and replicate within cardiac tissue8. Manifestations of heart involvement are varied, and range from endocarditis and pericarditis, to fulminant myocarditis complete with conduction abnormalities9-13. The overall number of L. monocytogenes cardiac cases per year is low but may be under estimated as this facet of infection is not generally well recognized. Colonization of the heart by pathogens often requires host predispositions such as pre-existing valvular damage or artificial heart valves. There are, however, isolates of L. monocytogenes that have been identified that are notable for their capacity to colonize the hearts of infected animals in the absence of any cardiac damage and/or abnormalities8.
Herein are described in vitro and in vivo methods for assessing bacterial colonization of cardiac tissue within infected animals using invasion assays in tissue culture as well as live animal infections. These methods have proven useful in not only for identifying strains with the potential to colonize cardiac tissue in infected animals, but should also be useful for the identification of bacterial gene products that serve to enhance cardiac cell invasion and/or result in changes in heart pathology. These methods facilitate the comparison of cardiotropism between multiple strains. For the methods described here, L. monocytogenes 10403S is used as a well-studied representative of a non-cardiotropic strain and the clinical isolate 07PF0776 is used as a representative example of a cardiotropic strain. These two strains were chosen to provide a comparison for bacterial invasion of cardiac cells in vitro and colonization of hearts of infected mice in vivo. The isolate 07PF0776 is a clinical isolate recovered from an interventricular abscess that caused a fatal arrhythmia in an HIV+ patient8. L. monocytogenes isolates may vary in their virulence potential, and given the propensity for Listeria to infect persons with immunosuppression and pregnant women, persons within these populations should exercise caution while assessing different clinical isolates.