Many bacterial species produce capsular polysaccharides that contribute to pathogenesis through evasion of the host innate immune system. The gram-positive pathogen Enterococcus faecalis was previously reported to produce one of four capsule serotypes (A, B, C, or D). Previous studies describing the four capsule serotypes of E. faecalis were based on immunodetection methods; however, the underlying genetics of capsule production did not fully support these findings. Previously, it was shown that capsule production for serotype C (Maekawa type 2) was dependent on the presence of nine open reading frames (cpsC to cpsK). Using a novel genetic system, we demonstrated that seven of the nine genes in the cps operon are essential for capsule production, indicating that serotypes A and B do not make a capsular polysaccharide. In support of this observation, we showed that serotype C and D capsule polysaccharides mask lipoteichoic acid from detection by agglutinating antibodies. Furthermore, we determined that the genetic basis for the difference in antigenicity between serotypes C and D is the presence of cpsF in serotype C strains. High-pH anion-exchange chromatography with pulsed amperometric detection analysis of serotype C and D capsules indicated that cpsF is responsible for glucosylation of serotype C capsular polysaccharide in E. faecalis.Enterococcus faecalis is a gram-positive bacterium commonly found as a commensal organism in the gastrointestinal tracts of most mammals. E. faecalis is one of the leading causes of hospital-acquired urinary tract infections, bacteremia, and surgical-site infections (29). The development of multiple antibiotic resistances, including resistance to vancomycin, makes treatment of enterococcal infections difficult (11). The 2004 National Nosocomial Infections Surveillance report indicated that nearly 30% of enterococci isolated from clinical settings were resistant to vancomycin, constituting a 12% rise from the previous 5 years (26). The development of alternative therapies to treat enterococcal infections has frequently been suggested due to rising percentages of antibiotic-resistant enterococcal strains (13)(14)(15)19).Capsular polysaccharides are major contributors to the virulence of many microorganisms. The presence of capsule allows these microbes to escape detection and clearance by the host immune system (9, 27, 30, 41). There have been several publications regarding the role of cell wall polysaccharides in the pathogenesis of enterococcal infections (10,13,17,37,43). Several attempts have been made to establish a serotyping system for E. faecalis capsular polysaccharides (16,23,35,36). These serotyping schemes include differences in capsular polysaccharide antigens but are also based on differences in surface antigens, including lipoteichoic acid (16, 38). To date, only one study has linked genetic evidence with capsule production (12). Two loci that have been reported to contain putative genes for capsule production are the epa and cps operons (10, 42). The polysaccharide...