Variable Adherence of Uropathogenic Escherichia Coli to Epithelial Cells from Women with Recurrent Urinary Tract Infection

Abstract

The adherence of 74 Escherichia coli strains to vaginal and buccal epithelial cells from women with recurrent urinary tract infections was studied. The strains were isolated from the urine, vaginal introitus or anal mucosa of women with recurrent bacteriuria. Vaginal and anal isolates were judged to be associated with urinary tract infection if they had the same biotype and serotype as the strain isolated subsequently from the urine. Adherence levels of urinary and anal isolates, and vaginal isolates associated with urinary tract infection were similar for vaginal and buccal cells. Adherence of vaginal isolates not associated with urinary tract infection was significantly lower than adherence of urinary isolates for vaginal (p less than 0.001) and buccal (p less than 0.005) epithelial cells. A positive nonlinear correlation between vaginal and buccal adherence was observed for urinary (r equals 0.87, p less than 0.0001), vaginal (r equals 0.70, p less than 0.0005) and anal (r equals 0.32, p equals 0.047) isolates. Strains of O-serogroups commonly and less commonly associated with bacteriuria had similar adherence. The results suggest that adherence of vaginal isolates is associated with the ability to cause urinary tract infections. The strong correlation between vaginal and buccal cell receptivity suggests that susceptibility to such infections may be controlled by genotypic traits.