Pathogenesis of urinary tract infection in the elderly: the role of bacterial adherence to uroepithelial cells
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The in vitro adherence of nine strains of Gram-negative bacteria to uroepithelial cells from 24 women patients (>65 years) was significantly higher than to cells from 24 premenopausal women (18–40 years). Uroepithelial cells from patients with a history of previous urinary tract infection (UTI) were marginally more receptive to attachment of uropathogens than cells from women without a history of UTI, but this was not statistically significant. Serum from four elderly women with asymptomatic bacteriuria was used to stabilize samples for electron-microscopic examination, which showed the presence of fibrous glycocalyx material surrounding the bacteria and attached to the uroepithelial cells. Eighty uropathogenic isolates from elderly and premenopausal women were found to express adhesins, to produce urease and hemolysins, and to ferment sucrose, salicin, and dulcitol. These results suggest that the increased receptivity of uroepithelial cells to bacterial attachment may be a predisposing factor in the onset of UTI in the hospitalized and domiciliary elderly population.
KeywordsSucrose Urinary Tract Urinary Tract Infection Elderly Population Premenopausal Woman
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