Uropathogenic Escherichia Coli: Molecular Mechanisms of Adherence

  • Gary K. Schoolnik
  • Peter O’Hanley
  • David Lark
  • Staffan Normark
  • Kenneth Vosti
  • Stanley Falkow
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 224)


Escherichia coli isolated from endogenous infections of the urinary tract usually originate in the colon (1–3). From the stool, uropathogenic strains colonize the vaginal introitus and periurethral region (4). Colonization of uroepithelium may ensue, leading to bacteriuria. Symptoms arise when invasion of mucosa, cell death, and inflammation occur in the bladder or kidney. Therefore, cystitis and pyelonephritis may be viewed as the culmination of a sequence of events mediated by specific determinants of microbial virulence. It follows that uropathogenic E. coli are not simply the most prevalent fecal stains. Instead, they appear to manifest a pathogenic phenotype: they usually belong to a restricted number of O and K antigen serogroups (3–5); they are resistant to the bactericidal action of normal human serum (6–8); they secrete hemolysin (9–11), produce colicin V (12–13), and ferment salicin (14); and they attach to uroepithelial cells in vitro (15–17).


Blood Group System Human Uroepithelial Cell Receptor Compound Blood Group Phenotype Colicin Versus 
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  1. 1.
    Vosti, K.L., L.M. Goldberg, A.S. Monto and L.A. Rantz. Host-parasite interaction in patients with infections due to Escherichia coli. I. The serogrouping of E. coli from intestinal and extraintestinal sources, J. Clin. Invest. 43:2377 (1964).PubMedCrossRefGoogle Scholar
  2. 2.
    Turck, M. and R.G. Petersdorf. The epidemiology of non-enteric Escherichia coli infections: prevalence of serological groups, J. Clin. Invest. 41:1760 (1962).PubMedCrossRefGoogle Scholar
  3. 3.
    Svanborg-Eden, C. Attachment of Escherichia coli to human urinary tract epithelial cells, Scand. J. Infect. Dis. 15(suppl): 1 (1978).Google Scholar
  4. 4.
    Fowler, J.E. and T.A. Stamey. Studies of introital colonization in women with recurrent urinary infections. VII. The role of bacterial adherence, J. Urol. 117:472 (1977).PubMedGoogle Scholar
  5. 5.
    Hagberg, L., U. Jodal, T. Korhonen, G. Lidin-Janson, U. Lindberg and C. Svanborg-Eden. Adhesion, hemagglutination and virulence of Escherichia coli causing urinary tract infections. Infect. Immun. 31:564 (1981).PubMedGoogle Scholar
  6. 6.
    Binns, M., D. Davies and K. Hardy. Cloned fragments of the plasmid Col V, I-K94 specifying virulence and serum resistance. Nature 279:778 (1979).PubMedCrossRefGoogle Scholar
  7. 7.
    Bjorksten, B. and B. Kaijser. Interaction of human serum and neutrophils with Escherichia coli strains: differences between strains isolated from urine of patients with pyelonephritis or asymptomatic bacteriuria. Infect. Immun. 22:308 (1978).PubMedGoogle Scholar
  8. 8.
    Oiling, S. Sensitivity of gram negative bacilli to the serum bactericidal activity: a marker of host-parasite relationship in acute and persisting infections, Scand. J. Infect. Dis. 10(suppl): 1 (1977).Google Scholar
  9. 9.
    Minshew, B.H., J. Jorgensen, G. Counts and S. Falkow. Association of hemolysin production, hemagglutination of human erythrocytes, and virulence for chicken embryos of extraintestinal Escherichia coli isolates. Infect. Immun. 20:50(1979).Google Scholar
  10. 10.
    Cooke, M.. and S. Ewins. Properties of strains of Escherichia coli isolated from a variety of sources, J. Med. Microbiol. 8:107 (1975).PubMedCrossRefGoogle Scholar
  11. 11.
    Evans, D., D. Evans, C. Hohne, M.A. Noble, E.V. Haldane, H. Lior and L.S. Young. Hemolysin and K antigens in relation to serotype and hemagglutination type of Escherichia coli isolated from extraintestinal infections, J. Clin. Microbiol. 13:171 (1981).PubMedGoogle Scholar
  12. 12.
    Brooks, H., F. O’Grady, M. McSherry and W. Cattel. Uropathogenic properties of Escherichia coli in recurrent urinary-tract infection, J. Med. Microbiol. 13:57 (1980).PubMedCrossRefGoogle Scholar
  13. 13.
    Davies, D., F. Falkiner and K. Hardy. Colicin V production by clinical isolates of Escherichia coli. Infect. Immun. 31:574 (1981).PubMedGoogle Scholar
  14. 14.
    Minshew, R.H., J. Jorgensen, M. Swanstrum, G. Grootes-Reuvecamp and S. Falkow. Some characteristics of Escherichia coli strains isolated from extraintestinal infections of humans, J. Infect. Dis. 137:648 (1978).Google Scholar
  15. 15.
    Svanborg-Eden, C., B. Eriksson and L. Hanson. Adhesion of Escherichia coli to human uroepithelial cells in vitro, Infect. Immun. 18:767 (1977).Google Scholar
  16. 16.
    Leffler, H., H. Lemberg, E. Gotschlich, et al. Chemical and clinical studies on the interaction of Escherichia coli with host glycolipid receptors in urinary tract infection, Scand. J. Infect. Dis. 33(suppl):46 (1981).Google Scholar
  17. 17.
    Kallenius, G. and J. Winberg. Bacterial adherence to periurethral epithelial cells in girls prone to urinary tract infections. Lancet II:240 (1978).Google Scholar
  18. 18.
    Orskov, I., A. Ferencz, F. Orskov. Tamm-Horsfall protein or uromucoid is the normal urinary slime that traps Type 1 fimbriated Escherichia coli. Lancet 1:887 (1980).PubMedCrossRefGoogle Scholar
  19. 19.
    Salit, I. and E. Gotschlich. Hemagglutination by purified type 1 Escherichia coli pili, J. Exp. Med. 146:1169 (1977).PubMedCrossRefGoogle Scholar
  20. 20.
    Salit, I. and E. Gorschlich. Type 1 Escherichia coli pili: characterization of binding to monkey kidney cells, J. Exp. Med. 146:1182 (1977).PubMedCrossRefGoogle Scholar
  21. 21.
    Leffler, H. and C. Svanborg-Eden. Chemical identification of a glycosphingolipid receptor for Escherichia coli attaching to human urinary tract epithelial cells agglutinating human erythrocytes, FEMS Microbiol. Lett. 8:127 (1980).CrossRefGoogle Scholar
  22. 22.
    Kallenius, G., R. Mollby, S.B. Svenen, J. Winberg, A. Lundblad, S. Svens son and B. Ceder gren. The p antigen as receptor for the hemagglutination of pyelonephritogenic Escherichia coli, FEMS Microbiol. Lett. 7:297 (1980).Google Scholar
  23. 23.
    O’Hanley, P., D. Lark, S. Normark, S. Falkow and G. SchooInik. Mannose-sensitive and Gal-Gal binding Escherichia coli pili from recombinant strains, J. Exp. Med. 158:1713 (1983).PubMedCrossRefGoogle Scholar
  24. 24.
    Vaisanen, V., J. Elo, L. Tallgren, H. Shtonen, P. Helena Makela, C. Svanborg-Eden, G. Kallenius, S.B. Svenson, H. Hultberg and T. Korhonen. Mannose-resistant hemagglutination and P antigen recognition characteristic of E. coli causing primary pyelonephritis. Lancet II:1366 (1981).Google Scholar
  25. 25.
    Sheladia, W., J. Chambers, J. Guevara and D. Evans. Isolation purification and partial characterization of type V-A hemagglutinin from Escherichia coli GV-12, 01:H, J. Bacteriol. 152:757 (1982).PubMedGoogle Scholar
  26. 26.
    Kallenius, G., R. Mollby, S. Svenson, I. Helin, H. Hultberg, B. Cedegren and J. Winberg. Occurence of P-fimbriated Escherichia coli in urinary tract infections. Lancet II:1369 (1981).Google Scholar
  27. 27.
    Hull, R., R. Gill, P. Hsu, B. Minshew and S. Falkow. Construction and expression of recombinant plasmids encoding Type 1 or D-mannose-resistant pili from a urinary tract infection Escherichia coli isolate; Infect. Immun. 33:933 (1981).PubMedGoogle Scholar
  28. 28.
    Kaijser, B. and P. Larsson. Experimental acute pyelonephritis caused by enterobacteria in animals. A review, J. Urol. 127:786 (1982).PubMedGoogle Scholar
  29. 29.
    Svanborg-Eden, C., R. Preter, L. Hagberg et al Inhibition of experimental ascending urinary tract infection by an epithelial cell-surface receptor analogue. Nature 298:560 (1982).CrossRefGoogle Scholar
  30. 30.
    Tamm, I. and F. Horsfall. A mucoprotein derived from human urine which reacts with influenza, mumps, and Newcastle disease viruses, J. Exp. Med. 95:71 (1952).PubMedCrossRefGoogle Scholar
  31. 31.
    O’Hanley, P., D. Lark, S. Falkow and G. Schoolnik. Molecular basis of Escherichia coli colonization of the upper urinary tract in Balb/c mice: Gal-Gal pili immunization prevents E. coli pyelonephritis in the Balb/c mouse model of human pyelonephritis, J. Clin. Invest. 75:347 (1985).PubMedCrossRefGoogle Scholar
  32. 32.
    McMichael, J. and J. Ou. Structure of common pili from Escherichia coli, J. Bacterid. 138:969 (1979).Google Scholar
  33. 33.
    Svanborg-Eden, C., E. Gotschlich, T. Korhonen, H. Leffler and G. Schoolnik. Aspects on structure and function of pili on uropathogenic Escherichia coli; Prog. Allergy 23:189 (1983).Google Scholar
  34. 34.
    Klemm, P., I. Orskov and F. Orskov. F7 and type 1-like fimbriae from three Escherichia coli strains isolated from urinary tract infections: protein chemical and immunological aspects. Infect. Immun. 36:462 (1982).PubMedGoogle Scholar
  35. 35.
    Svanborg-Eden, C. and U. Jodal. Attachment of Escherichia coli to sedimented epithelial cells from urinary tract infection-prone and healthy children. Infect. Immun. 26:837 (1979).PubMedGoogle Scholar
  36. 36.
    Lomberg, H., L. Hanson, B. Jacobsson, U. Jodal, H. Leffler and C. Svanborg-Eden. Correlation of P blood group, vesicoureteral reflux, and bacterial attachment in patients with recurrent pyelonephritis, N. Engl. J. Med. 308:1189 (1983).PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • Gary K. Schoolnik
    • 1
  • Peter O’Hanley
    • 1
  • David Lark
    • 1
  • Staffan Normark
    • 1
  • Kenneth Vosti
    • 1
  • Stanley Falkow
    • 1
  1. 1.Medical Service, Palo Alto Veterans Administration Medical Center, and the Departments of Medicine and Medical MicrobiologyStanford University School of MedicineStanfordUSA

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