Mannose-Resistant Hemagglutination and P Receptor Recognition of Uropathogenic Escherichia coli Isolated from Adult Patients

Abstract

Adhesions of 211 strains of uropathogenic Escherichia coli and 19 strains of normal fecal E. coli were characterized by patterns of agglutination with human erythrocytes, Saccharomyces cerevisiae, and horse erythrocytes coated with the P blood-group receptor (P). Mannose-resistant (MR) hemagglutination was significantly associated with P agglutination (P less than .001). E. coli expressing MR and/or P (MR/P) agglutinins concurrently with mannose-sensitive (MS) agglutinins predominated in all clinical categories. The highest percentage of E. coli demonstrating MR/P agglutinins, in the absence of MS agglutinins, was recovered from patients with acute pyelonephritis (35%) compared with percentages of patients with chronic pyelonephritis (13%), asymptomatic bacteriuria (16%), cystitis (11%), and normal fecal control E. coli (11%). Sixty-nine percent of E. coli isolates causing acute pyelonephritis agglutinated P-coated horse erythrocytes compared with only 11% of the fecal isolates. Strains expressing MR/P agglutinins (in the absence of MS agglutinins) isolated from patients with acute pyelonephritis, chronic pyelonephritis, and asymptomatic bacteriuria were significantly associated with the presence of antibody-coated bacteria in patients' urine sediments (P less than .010), an observation indicative of an immune response associated with bacterial invasion of host tissues.

Virulence factors in Escherichia coli urinary tract infection

“…Studies of women with UTI in which the site of infection is determined by localization techniques (bladder washout, ureteral catheterization, or the antibody-coated-bacteria test) demonstrate that the proportion of strains expressing P fimbriae is greatest with acute pyelonephritis, lower with cystitis, and lowest with ABU, as would be expected from the results of other studies (Table 5) (146,295,372). Surprisingly, however, the proportion of strains expressing P fimbriae is similar between upper and lower urinary tract isolates within each clinical category (146,295,372). This seemingly paradoxical dissociation of anatomical location and clinical manifestations of infection would be explained if P fimbriae are necessary not for upper tract infection per se but for the local and systemic signs of inflammation commonly used to define acute pyelonephritis.…”

“…However, determinations of the site of human infection (upper versus lower urinary tract) based on the clinical manifestations of UTI are often inaccurate (231). Studies of women with UTI in which the site of infection is determined by localization techniques (bladder washout, ureteral catheterization, or the antibody-coated-bacteria test) demonstrate that the proportion of strains expressing P fimbriae is greatest with acute pyelonephritis, lower with cystitis, and lowest with ABU, as would be expected from the results of other studies (Table 5) (146,295,372). Surprisingly, however, the proportion of strains expressing P fimbriae is similar between upper and lower urinary tract isolates within each clinical category (146,295,372).…”

“…Investigators using serial passage in unshaken broth to promote fimbrial expression (230,393) report higher levels of expression than do those using a single passage or passage on agar (15). There is little evidence that type 1-fimbrial production is less common among strains from compromised patients than among those from noncompromised patients (15,146,230 (20,367 (26,576). Strains with the aerobactin system have a growth advantage in low-iron conditions (40, 361,608), including in serum and dilute urine.…”

Association between Antibiotic Resistance and the Expression of Dr Adhesin among Uropathogenic <i>Escherichia coli</i>

“…Bacterial cells were tested for their ability to agglutinate human 'O' erythrocytes. All the agglutinations were performed with O erythrocytes washed with phosphate-buffered saline (PBS) in the presence or absence of 2% ·-methyl-D-mannopyranoside [23]. Briefly, 25 Ìl of 3% O erythrocytes was mixed with an equal volume of bacterial suspension 99 containing 1.6-3.2 !…”

Demonstration by immuno-electronmicroscopy of antigenic heterogeneity among P fimbriae of strains of Escherichia coli

“…It is important, therefore, that a range of culture media should be employed to detect the maximal expression of MRE-HA activity of all strains of E. coli. Caution is even more relevant for those P-fimbriate strains of E. coli that do not agglutinate human erythrocytes when grown on media traditionally chosen for MRE-HA production (Gander et al, 1985 ;Yakubu, 1986). The susceptibility of different erythrocytes to agglutination by our P-fimbriate strains correlated roughly with their content of globoseries-glycolipid receptor.…”