Association of in Vitro Escherichia coli Adherence to Vaginal and Buccal Epithelial Cells with Susceptibility of Women to Recurrent Urinary-Tract Infections

Anthony J. Schaeffer*, Joanne M. Jones, Judith K. Dunn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

139 Scopus citations

Abstract

To identify changes in epithelial cells that were associated with susceptibility to recurrent urinary-tract infections, we investigated the adherence of Escherichia coli to vaginal and buccal cells obtained from 11 healthy controls and 24 patients who had had at least three such infections in the preceding year. Adherence to vaginal cells was greater in patients than in controls (10.1±0.92 vs. 3.8±0.47 bacteria per cell [mean ±S.E.], P<0.001), as was adherence to buccal cells (11.7±1.29 vs. 7.1±0.49, P = 0.002). This increased adherence in patients persisted despite temporary remission of the infection. Vaginal cells from patients not receiving antimicrobial prophylaxis had greater adherence than cells from patients given prophylactic therapy (11.7±1.34 vs. 8.3±1.0; P = 0.027). The range and rapidity of change in adherence as well as in vivo colonization of the vaginal mucosa were greater in patients than controls. Our data suggest that susceptibility to urinary-tract infections in women is associated with changes in the adhesive characteristics of epithelial cells. (N Engl J Med. 1981; 304: 1062–6.) LONGITUDINAL studies in women have established that bacteriuria is frequently preceded by colonization of the vaginal mucosa with the organism responsible for the infection.1 Cultures obtained from patients between their episodes of bacteriuria showed both a higher incidence and a greater density of vaginal colonization with urinary pathogens when compared with similar cultures from women2,3 and girls4 who had never had this infection. Adherence of bacteria to epithelial cells is important in the colonization of mucous membranes.5 6 7 The concept that adherence of bacteria to vaginal epithelial cells plays a part in the pathogenesis of vaginal colonization has been both supported. . .

Original languageEnglish (US)
Pages (from-to)1062-1066
Number of pages5
JournalNew England Journal of Medicine
Volume304
Issue number18
DOIs
StatePublished - Apr 30 1981

ASJC Scopus subject areas

  • Medicine(all)

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