Several problems have been encountered with the application of published methods for the study of bacterial adherence to isolated uroepithelial cells. Of particular importance is the observation that urinary mucus traps some organisms but not others. Established techniques have been modified to overcome these difficulties and so allow a distinction to be made between adherence of bacteria to uromucoid and adherence to uroepithelial cells per se. The modified method was used to assess the ability of 34 urinary isolates of Escherichia coli to adhere to uroepithelial cells, uromucoid, or both after serial subculture in nutrient broth. The ability of the organisms to produce mannose-sensitive (MS) agglutination of guinea pig erythrocytes and mannose-resistant (MR) agglutination of human erythrocytes was tested simultaneously and taken to indicate possession of MS type 1 fimbriae andated MR fimbriae, respectively. Results revealed that only MS-positive organisms adhered to uromucoid (P < 0.001), whereas MR-positive strains showed significantly greater attachment to uroepithelial cells than did MR-negative strains (P < 0.05). These observations demand that published data derived from the use of a methodology in which no differentiation can be made between adherence to uromucoid and adherence to cells should be interpreted with caution.
Bioluminescence ATP analysis has been used to assess bacterial adhesion with hydrophobic polystyrene tubes as the attachment surface. The assay was performed at 37 degrees C and pH 6.8 with a 10 min incubation period. A variation of more than 200-fold was observed in the adherence capacity of 34 urinary isolates of Escherichia coli, and organisms could be classified as strongly or weakly adherent. All strains capable of strong adhesion possessed both type 1 fimbriae and flagella, and maximum adhesion was expressed during the exponential growth phase. Attachment was in all cases virtually eliminated by addition of 2.5% (w/v) D-mannose to the incubation buffer. Conversely, strains which were deficient in type 1 fimbriae or flagella, or both, were weakly adherent during all phases of growth. There was no correlation between adherence of E. coli to polystyrene and adherence to buccal or uroepithelial cells, but there was a significant association with adherence to uromucoid (P less than 0.002).
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