Adhesion to a human cell line by Escherichia coli strains isolated during urinary tract infections

It has been shown that some, but not all, Escherichia coli strains isolated from urine adhere, in vitro, to the surface of uroepithelial or vaginal cells. In the present study, 212 strains, isolated from urine of 212 infected patients, were tested for adhesion by using an in vitro human cell line assay. A variable degree of attachment to the cell monolayer was detected in these strains. From patients with cystitis, only 19 (9.7%) of the 195 strains examined were adherent, whereas 5 (29.4%) of the 17 pyelonephritis strains had similar properties (P less than 0.05). To investigate the incidence of adhesion in the clinical manifestations of urinary tract infection, a sample of patients was picked at random from those with cystitis. During cystitis caused by adhesive bacteria, patients suffer more often from macroscopic hematuria than from dysuria, frequency, or recurrency (P less than 0.05). This study shows that E. coli strains isolated from urine samples possess a strikingly difference in capacity to adhere to a human cell line surface as demonstrated previously with uroepithelial or vaginal cells. Moreover, according to these data, the adhesion of E. coli may be considered as a virulent factor and would play a part in the infection of the urinary tract in humans.