In several gram-negative bacterial pathogens, autoagglutination (AAG) activity is a marker for interaction with host cells and virulence. Campylobacter jejuni strains also show AAG, but this property varies considerably among strains. To examine the characteristics of C. jejuni AAG, we developed a quantitative in vitro assay. For strain 81-176, which shows high AAG, activity was optimal for cells grown for <24 h, was independent of growth temperature, and was best measured for cells suspended in phosphate-buffered saline at 25°C for 24 h. AAG activity was heat labile and was abolished by pronase or acid-glycine (pH 2.2) treatment but not by lipase, DNase, or sodium metaperiodate. Strain 4182 has low AAG activity, but extraction with water increased AAG, suggesting the loss of an inhibitor. Strain 6960 has weak AAG with no effect due to water extraction. Our study with clinical isolates suggests that C. jejuni strains may be grouped into three AAG phenotypes. A variant derived from strain 81116 that is flagellate but immotile showed the strong AAG exhibited by the parent strain, suggesting that motility per se is not necessary for the AAG activity. AAG correlated with both bacterial hydrophobicity and adherence to INT407 cells. Mutants which lack flagella (flaA, flaB, and flbA) or common cell surface antigen (peb1A) were constructed in strain 81-176 by natural transformation-mediated allelic exchange. Both AAG activity and bacterial hydrophobicity were abolished in the aflagellate mutants but not the peb1A mutant. In total, these findings indicate that C. jejuni AAG is highly associated with flagellar expression.Campylobacter jejuni now is recognized as an important enteropathogenic bacterium of humans (51, 57). C. jejuni colonizes the intestinal tract of domesticated animals, and ingestion of contaminated water, milk, or meat products and direct contact with infected pets are considered the most important sources of infection in humans (3, 53). Although there have been many reports about virulence-related factors for C. jejuni such as toxin production (17,28,34,45,59), adherence to tissue (5,8,18,29,43), and invasion of tissue (19,20,22,23,38,47,60), their contribution to pathogenesis has not been clearly understood. Although tests for these virulence markers are available for presumptive determination of the pathogenic potential of C. jejuni isolates (20,26,33), as described for other enteropathogens, these tests often are difficult and expensive to perform and results cannot be immediately obtained in most cases. Despite the recent determination of the C. jejuni genomic sequence (41), simple and rapid methods for assessing pathogenicity are not yet available and are needed.Autoagglutination (AAG) activity is known to be a marker of virulence in several gram-negative bacterial pathogens, including Vibrio cholerae (4), Bordetella pertussis (30), Neisseria gonorrhoeae (54), and Yersinia (25, 46) and Aeromonas (16, 21, 42) species. Pilins (4, 54) or outer membrane proteins (52) of these bacteria have been demonstr...