Characterization of enterotoxigenic Escherichia coli (ETEC) has been based almost exclusively on the detection of phenotypic traits such as serotypes and virulence-associated factors: heat-labile (LT) and heatstable (ST) toxins and colonization factors (CFs).In the present work we show that the analysis of band patterns generated by randomly amplified polymorphic DNA (RAPD) analysis and pulsed-field gel electrophoresis (PFGE) of digested chromosomal DNA can be used to detect genetic diversity among ETEC strains expressing identical phenotypic traits. The study included 29 ETEC isolates from Latin America and Spain expressing the phenotype O153:H45 CFA/I ST plus 1 rough derivative, 2 nonmotile derivatives, and 1 O78:H12 CFA/I ST isolate, and a representative of a genetically distinct ETEC group. The results showed that the O153:H45 CFA/I ST ETEC isolates belong to a single clonal cluster whose isolates share on average, 84% of the RAPD bands and 77% of the PFGE restriction fragments, while the O78:H12 isolate shared only 44 and 4% of the RAPD bands and PFGE fragments, respectively, with the isolates of the O153:H45 group. More relevantly, RAPD and PFGE fingerprints disclosed the presence of different clonal lineages among the isolates of the O153:H45 cluster. Some of the genetic variants were isolated from defined geographic areas, while places like São Paulo City in Brazil and the middle-eastern part of Argentina were populated by several genetic variants of related, but not identical, ETEC strains. These results show that molecular biology-based typing methods can disclose strain diversity, which is usually missed in studies restricted to phenotypic typing of ETEC.Enterotoxigenic Escherichia coli (ETEC) represents one of the main etiologic agents of diarrhea in infants and travelers in developing countries (5). ETEC strains are identified by the ability to produce enterotoxins, either heat-labile toxin or heatstable toxin (ST), or both, and surface adhesins known as colonization factors (CFs). Also, characterization of ETEC strains has relied on the serological determination of a number of different combinations of O (lypopolyssacharide) and H (flagellar) serogroups (4,7,11,13,28). Antigen heterogeneity is a striking feature among ETEC strains, as demonstrated in a survey that evaluated the diversity, distribution, and association of ETEC phenotypes in epidemiological studies carried out in different parts of the world (31).The application of DNA-based typing methods to investigate the genetic relationship among ETEC strains isolated from humans has been rare (16,19). Previous studies, based on the use of randomly amplified polymorphic DNA (RAPD) analyses, indicated that, in contrast to other pathogenic E. coli groups (8, 30), ETEC strains that share an O:H serotype but not necessarily the same virulence-associated factors belong to clonal clusters (21,22,23). Moreover, RAPD analysis can reveal variant genotypes among ETEC strains that share the same O:H serotype and that belong to the same clonal cluster (22, ...