Enteropathogenic Escherichia coli (EPEC) strains cause watery diarrhea almost exclusively in young children. The basis for this age discrimination has never been determined, but it may be related to host cell receptors. During infection, EPEC strains express type IV bundle-forming pili composed of repeating subunits of the protein called bundlin. The very first interaction between EPEC and in vitro-cultured epithelial cells is mediated by the binding of ␣-bundlin to a carbohydrate receptor that contains, at a minimum, the Nacetyllactosamine (LacNAc) glycan sequence. However, bundlins expressed from the -bundlin allele do not bind LacNAc glycan sequences. Herein, we investigated whether EPEC strains use ␣-bundlin to mediate early adherence to human intestinal biopsy specimens cultured in vitro by assessing the ability of isogenic EPEC mutants expressing either the ␣ 1 -or  1 -bundlin allele or a bundlin-deficient EPEC strain to bind to these specimens. Furthermore, we directly compared the abilities of a wild-type EPEC strain to bind to the epithelial surfaces of both human adult and pediatric biopsy specimens. Our results demonstrate that -bundlin does not act as an adhesin during early EPEC adherence to adult duodenal biopsy specimens. The results also indicate that EPEC binds equally well to adult and pediatric biopsy specimens in an early adherence assay. This result is supported by the finding that the early adherence of EPEC to both adult and pediatric biopsy specimens was inhibited by LacNAc neoglycoconjugates, suggesting that organisms expressing ␣-bundlin-type bundle-forming pili initially bind to related glycan receptors in both age groups.Enteropathogenic Escherichia coli (EPEC) strains cause watery diarrhea in young children, an illness associated with the EPEC-mediated disruption of the small-intestinal epithelium (21,22,24). While EPEC strains cause clinical disease predominantly in children under the age of 2 years, disease can also be elicited in adult volunteers given a very high infectious dose of bacteria (1, 7, 9, 11). The basis for this age discrimination by EPEC has never been determined but may be related to either differences in susceptibility to EPEC colonization between adults and infants or to acquired protective immunity from repeated infections in adults.EPEC pathogenesis is dependent on a two-stage mechanism of adherence of the bacteria to host enterocytes. In the first step, EPEC cells bind to the host cell via their type IV bundleforming pili (BFP) in a process known as localized adherence (LA). Following LA, EPEC strains inject effector proteins and their own receptor, a protein called the translocated intimin receptor (Tir), into the host cell via a type III secretion system. Tir is inserted into the host cell plasma membrane, where it acts as the receptor for the EPEC adhesin intimin and recruits cytoskeletal components, the net effect of which is the effacement of the microvilli and the formation of actin-rich pedestals at the site of EPEC adherence. This is known as the att...