Influence of P blood group phenotype on susceptibility to urinary tract infection.

Bacterial attachment is an important event in the pathogenesis of urinary tract infection (UTI). Increased receptivity on the host cells has been suggested influence proneness to infection. The dual function of the globoseries of glycolipids both as receptors for attaching E. coli and as P blood group antigens lead us to examine the P blood group phenotype distribution in UTI prone patient populations. A correlation between the P1 blood group phenotype and susceptibility to UTI was found. Patients with recurrent pyelonephritis had 74/79 (94%), P1 compared to 75% in healthy controls. In contrast patients with asymptomatic bacteriuria (ABU) had a reduced frequency of P1, 43/74 (58%). P1 and P2 individuals differ in amount and composition of the globoseries of glycolipids on their erythrocytes. A similar difference in other tissues, e.g. uroepithelial cells might explain the association of P1 with UTI. There was, however, no significant difference in bacterial adherence to uroepithelial cells from P1 and P2 individuals. Other mechanisms explaining the increase in P1 individuals in recurrent pyelonephritis are discussed.