We identified many variable-number tandem repeat (VNTR) loci in the genomes of Neisseria meningitidis serogroups A, B, and C and utilized a number of these loci to develop a multiple-locus variable-number tandem repeat analysis (MLVA). Eighty-five N. meningitidis serogroup B and C isolates obtained from Dutch patients with invasive meningococcal disease and seven reference strains were analyzed using MLVA and multilocus sequence typing (MLST). MLVA, based on eight VNTR loci with limited variability in the number of repeats, yielded clustering of the strains similar to that obtained by MLST, with congruence between both methods amounting to 69%. The ability to recognize clonal complexes makes MLVA a valuable high-throughput method to serve as a tool complementary to MLST. Four highly variable VNTR loci were used in a second assay to analyze N. meningitidis serogroup C strains collected during an outbreak of meningococcal disease in The Netherlands. Typing based on the latter VNTR loci enabled differentiation of isolates with identical MLST sequence types and grouped epidemiologically related strains.Neisseria meningitidis remains a major cause of meningitis and septicemia worldwide (4, 24). On the basis of the structure of its capsule polysaccharide, 13 serogroups are recognized. Polysaccharide vaccines against serogroups A, C, Y, and W135 are available. Due to poor immunogenicity and cross-reactivity with neural tissue, a vaccine based on the serogroup B polysaccharide is not available. A licensed vaccine against serogroup B meningococci based on other components of the pathogen will not become available for some time. While disease due to serogroup A, W135, and C meningococci is prevalent in Africa and Asia, in Europe and the Americas serogroup B meningococci are causing most of the cases of meningococcal disease. Study of the epidemiology of N. meningitidis increases knowledge about the spread of the bacterium and has identified particular clones with apparent increased virulence (15,20). Many different typing techniques have been employed to characterize meningococci. This is particularly true for the molecular techniques, which range from multilocus enzyme electrophoresis to PorA variable region typing and multilocus sequence typing (MLST) (1,3,5,20,27,33). MLST can now be considered the gold standard for genotyping N. meningitidis, and a large database is accessible via the Internet (http://pubmlst.org/neisseria/). MLST of N. meningitidis is a method using sequence data obtained from seven housekeeping genes. The alleles from these housekeeping genes are assigned allele numbers, and the combination of these allele numbers makes up a sequence type. MLST is a portable technique yielding unambiguous results and has been shown to be very suited for global epidemiology of meningococci (9,20,21,31). However, despite these obvious advantages, MLST is a costly and labor-intensive typing technique. To type a single strain, seven PCRs and 14 sequence reactions are required. Recently, multiple-locus variable-number ta...