Studies of introital colonization in women with recurrent urinary infections. VII. The role of bacterial adherence.

The susceptibility of the vaginal introitus to colonization by enterobacteria appears to be the biologic defect that separates women who experience recurrent urinary infection from those resistant to recurrent infection. Colonization of a mucosal surface is mediated in part by the ability of an organism to adhere to the surface. We describe an in vitro model that measures the capacity of different bacterial species to adhere to human vaginal epithelial cells. Different bacteria are demonstrated to vary in their adhesive properties. Escherichia coli is shown to adhere more readily to vaginal cells from women with recurrent urinary infection than to similar cells from control women resistant to urinary infection (p less than 0.001). These studies suggest that biologic susceptibility to recurrent urinary infections in women is related to a defect at the cellular level that encourages or favors bacterial adherence.