The present study compared the recently developed multilocus sequence typing (MLST) approach with a well-established molecular typing technique, pulsed-field gel electrophoresis (PFGE), for subspecies differentiation of Enterococcus faecalis isolates. We sequenced intragenic regions of three E. faecalis antigen-encoding genes (ace, encoding a collagen and laminin adhesin; efaA, encoding an endocarditis antigen; and salA, encoding a cell wall associated antigen) and one housekeeping gene (pyrC) of 22 E. faecalis isolates chosen largely for their temporal and geographical diversity, but also including some outbreak isolates. MLST analysis of polymorphic regions of these four genes identified 13 distinct sequence types (STs) with different allelic profiles; the composite sequences generated from the four sequenced gene fragments of individual isolates showed 98.3 to 100% identity among the 22 isolates. We also found that the allelic profiles from two sequences, ace and salA, were sufficient to distinguish all 13 STs of this study. The 13 STs corresponded to 12 different PFGE types, with one previously designated PFGE clone (a widespread U.S. clone of -lactamaseproducing isolates) being classified into two highly related STs which differed at 2 of 2,894 bases, both in the same allele. MLST also confirmed the clonal relationships among the isolates of two other PFGE clonal groups, including vancomycin resistant isolates. Thus, this pilot study with representative E. faecalis isolates suggests that, similar to PFGE, the sequence-based typing method may be useful for differentiating isolates of E. faecalis to the subspecies level in addition to identifying outbreak isolates.Enterococci, normal gut commensals, were recognized as a causative agent of endocarditis and urinary tract infections in ca. 1900 and have also been reported as a common cause of nosocomial infections since the 1970s (25, 26). Recently, accumulation of antibiotic resistances has made enterococcal infections a life-threatening clinical challenge, and thus, the methods that distinguish an outbreak from an endogenous strain have become important for designing strategies to prevent and control outbreaks (24,26). A number of phenotypic or genotypic typing methods (including biochemical typing, serotyping, multilocus enzyme electrophoresis [MLEE], phage typing, insertion sequence element-based typing, pulsed-field gel electrophoresis [PFGE], restriction fragment length polymorphism [RFLP] analysis, ribotyping, repetitive sequence-based PCR, arbitrary primed PCR, and random amplification of polymorphic DNA) have been applied to the epidemiological investigations of Enterococcus faecalis (2-4, 6, 14, 18, 22, 28, 35, 40, 47, 48). These molecular and epidemiological studies have provided valuable information and clarified some misconceptions regarding E. faecalis infections, such as demonstrating that some E. faecalis infections are caused by nosocomial transmission of outbreak strains rather than arising from the patient's own prehospitalization intestinal...