Association of the Lewis Blood-Group Phenotype with Recurrent Urinary Tract Infections in Women

J. Sheinfeld, A. J. Schaeffer, C. Cordon-Cardo, A. Rogatko, W. R. Fair

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200 Scopus citations


Blood-group antigens are found on the surface of urothelial cells and may affect bacterial adherence and thereby the susceptibility to urinary tract infection. We determined the ABO, P, and Lewis blood-group phenotypes in 49 white women with histories of recurrent urinary tract infections and compared them with those found in 49 healthy control women without recurrent urinary tract infections. There was no significant difference between the two groups in the distribution of the ABO or P phenotypes. The distribution of Lewis blood-group phenotypes among control women was similar to that in the general population: secretor phenotype (Le(a-b+)), 74 percent; nonsecretor phenotype (Le(a+b-)), 18 percent; and recessive phenotype (Le(a-b-)), 8 percent. The following distribution was noted among the women with recurrent urinary tract infections: secretor phenotype, 45 percent; nonsecretor phenotype, 29 percent; and recessive phenotype, 26 percent (P = 0.002). When the women with nonsecretor and recessive phenotypes were combined and considered collectively, the odds ratio (an estimate of relative risk of recurrent urinary tract infection) for those without the secretor phenotype was 3.4 (95 percent confidence interval, 1.5 to 7.9). We conclude that there is an increased frequency of the Lewis blood-group nonsecretor (Le(a+b-)) and recessive (Le(a-b-)) phenotypes among women with recurrent urinary tract infections. THE attachment of bacteria to urothelial cells is an important factor in the pathogenesis of urinary tract infections.1 The receptors for uropathogenic organisms, particularly Escherichia coli, are carbohydrate residues located on the surface glycolipids and glycoproteins of urothelial cells.2 The carbohydrate composition of the surface of the urothelial cells is highly variable and influences the availability of these putative receptors to bind bacteria. An important factor in determining the complex-carbohydrate membrane structure of urothelial cells is a person's blood-group profile.2 Blood-group antigens are a group of carbohydrate determinants found on erythrocytes and certain epithelial tissues, including urothelium. The Lewis…

Original languageEnglish (US)
Pages (from-to)773-777
Number of pages5
JournalNew England Journal of Medicine
Issue number12
StatePublished - Mar 23 1989

ASJC Scopus subject areas

  • Medicine(all)


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