The role of bacterial adherence in urinary tract infections in elderly adults

In an attempt to clarify host factors responsible for the acquisition of bacteriuria in elderly adults, bacterial adherence to uroepithelial cells obtained from 83 elderly participants and 40 young controls was studied. Seven uropathogenic strains of E. coli expressing different adhesions were used. Bacteria adhered significantly better to cells of young women than young men (p less than .0001) and elderly women than elderly men (p less than .03). The greatest adherence was in young women and the least in young men. In women without bacteriuria, aging was not associated with increased susceptibility to bacterial attachment. Moreover, there was no increase in the adherence of E. coil strains to uroepithelial cells of bacteriuric elderly women in comparison to abacteriuric elderly women. In men, however, aging was associated with increased bacterial adherence (p less than .02). Susceptibility to bacterial adherence does not appear to be responsible for the increased frequency of E. coli bacteriuria in elderly women but may be a permissive factor in elderly men.