We used a two-chamber system to study transcytosis of Enterococcus faecalis across monolayers of human colon carcinoma-derived T84 cells, which show structural resemblance to the native intestine. Among 16 E. faecalis isolates from different sources, the well-characterized strain OG1RF and 8 other isolates (2 endocarditis isolates, 1 urine isolate, and all 5 fecal isolates) showed translocation in this assay, while 6 clinical isolates (3 endocarditis and 3 urine isolates), the recipient strain JH2-2, and the control, Escherichia coli DH5␣, had no detectable translocation. Of two OG1RF mutants involving the previously studied epa (enterococcal polysaccharide antigen) gene cluster, known to be needed for virulence and resistance to killing by polymorphonuclear leukocytes, one epa mutant (TX5179) was unable to translocate, while TX5180, with an epa disruption farther downstream, showed a moderate decrease in translocation relative to that of the wild-type strain OG1RF (P < 0.01), indicating that the epa gene cluster is important for translocation across a T84 monolayer. This observation was confirmed by complementation of the epa mutant (TX5179) with epa genes and restoration of its translocation ability. In conclusion, we have demonstrated translocation of at least some strains of E. faecalis across T84 monolayers, although strains differ considerably in this ability, and we have demonstrated that epa mutations can cause marked changes in successful translocation. These results suggest that this model may be a useful in vitro system for studying the process of translocation from the intestinal tract.Enterococci are part of the normal flora in human intestines and are also a leading cause of nosocomial infections (5, 12). These organisms seem to be able to migrate from the gastrointestinal tract into the bloodstream and cause systemic infections such as bacteremia and even endocarditis. The passage of bacteria from the gastrointestinal tract to extraintestinal sites is called translocation (1,22). Wells and colleagues have presented evidence that Enterococcus faecalis can translocate across the mouse intestinal tract (23). In their study, following E. faecalis overgrowth (elicited by metronidazole and streptomycin treatment after oral inoculation of E. faecalis resistant to these agents), coccal bacteria appeared in the intestinal lumen and were observed within vacuoles in the cytoplasm of epithelial cells (23). By immunofluorescent microscopy, E. faecalis cells were localized within columnar epithelial cells, lamina propria, submucosa, and muscularis externa. Thus, E. faecalis cells appear to be able to translocate across an intact intestinal tract, although the enterococcal traits involved in the process were not determined. Runkel et al. also reported that morphine, a known inhibitor of myoelectric activity in the intestines of rats that prolongs gut transit time, increases intestinal microflora levels and promotes bacterial translocation from the intestinal tract to extraintestinal sites (16).An in vitro transc...