The aim of this study was to examine whether a vaginal Escherichia coli colonization, mimicking the one seen in UTI-prone females, could be induced by amoxicillin administration. In adult cynomolgus monkeys, who carry the alpha-Gal-1-4-beta-Gal receptor for P-fimbriae, we have investigated the ability of a clinical isolate of P-fimbriated E. coli to colonize the mucous membranes of the genital tract. When the vagina was washed with a suspension of the P-fimbriated strain, a persistent colonization was obtained in only 17% (4/24) of the experiments. When such colonization attempts were performed during vaginal amoxicillin administration, a persistent and heavy colonization of the vagina occurred in 5/5 attempts. The findings do not contradict our hypothesis that antibiotics given to UTI-prone females may facilitate the establishment of the abnormal colonization of the genital tract.

Administration, Intravaginal↗

PubMedDate not supplied

P-fimbriae of pyelonephritogenic Escherichia coli: identification and chemical characterization of receptors.

Pyelonephritogenic Escherichia coli isolates were found to be equal in their ability to adhere to uroepithelial cells and to cause agglutination specific for human erythrocytes. This adhesive capacity was not affected by D-mannose and was found to be mediated by a new class of E. coli fimbriae named P-fimbriae. Using human erythrocytes of different blood groups, we found the receptor molecules for P-fimbriae to be associated with the P blood group antigens, i. e. glycosphingolipids corresponding to the P blood group antigens P, P1 and Pk. By agglutination studies of erythrocytes with various set-ups of these antigens as well as by inhibition studies using synthetic saccharide derivatives and by coating non-agglutinable erythrocytes with a synthetic glycolipid, the minimal receptor structure was identified as the alpha-D-Galp-(1-4)-beta-D-Galp moiety of the carbohydrate portion of these glycosphingolipids. Similar experiments on isolated uroepithelial cells proved that these glycosphingolipids also constitute the receptors in the urinary tract.

Adhesiveness↗

PubMedDate not supplied

P-fimbriae of pyelonephritogenic Escherichia coli: detection in clinical material by a rapid receptor-specific agglutination test.

A slide agglutination test to detect P-fimbriated Escherichia coli was developed by attaching glycosides containing the relevant receptor structure (alpha-D-Galp-(1-4)-beta-D-Galp) to particles. A suspension of these particles agglutinates within ten seconds when mixed with P-fimbriated bacteria. The test is named the P-specific particle agglutination test (PPA test). The PPA test is more sensitive than the haemagglutination assays previously used. The exclusive specificity of the PPA test also allows the detection of P-fimbriae on strains which additionally possess other fimbriae (e.g. X-fimbriae). Using this test, the frequency of P-fimbriated E. coli in children with acute non-obstructive pyelonephritis was shown to exceed 95%. In lower urinary tract infections the frequency of P-fimbriated E. coli was approximately 20%. Moreover, children with acute pyelonephritis were also found to be heavily colonized in both the periurethral area and the intestine with the identical P-fimbriated E. coli strain.

Adult↗

PubMedDate not supplied

P-fimbriae of pyelonephritogenic Escherichia coli: significance for reflux and renal scarring-a hypothesis.

An experimental pyelonephritis model was developed in monkeys (Macaca fascicularis) using P-fimbriated Escherichia coli as the infecting organism. The relevant receptor molecules for P-fimbriae were also shown to be present in Macaca fascicularis. Atraumatic administration of P-fimbriated E. coli into the ureter induced a ureteritis followed by acute and chronic pyelonephritis. The decisive role of P-fimbriae as an adhesive virulence factor was proven by the receptor blockade of P-fimbriae-mediated bacterial adhesion by a synthetic receptor analogue (alpha-D-Galp-(1-4)-beta-D-Galp-1-OMe), which was administered into the ureter together with the challenge bacteria. On the basis of these and other findings, the role of reflux and pyelonephritis in relation to renal scarring is discussed in this paper. It is proposed that minor transitional vesicoureteral reflux together with the adhesive property of P-fimbriated E. coli and their ability to induce ureteritis might constitute an alternative mechanism to gross reflux by which bacteria ascend to the kidney. These findings and the fact that intestinal colonization with P-fimbriated E. coli coincides with the disease have opened up new prophylactic and therapeutic possibilities.

Adhesiveness↗