Antibodies against E. coli O-antigens and common enterobacterial antigen in kidney-transplant recipients. Comparison of antibody findings with evidence of urinary tract infection.

Using indirect haemagglutination, sera from 45 patients who had undergone renal transplantation were examined for 0-antibodies against 10 selected uropathogenic E. coli strains, and against common enterobacterial antigen (anti-CA). Bilateral nephrectomy was carried out, usually less than three months after transplantation, and serum from the time of nephrectomy was examined. The aim was to correlate antibody findings with evidence of urinary tract infection (UTI), as assessed by significant bacteriuria or growth of bacteria from the nephrectomy specimens. All the sera contained antibodies against several of the E. coli strains, mostly in titres less than or equal to 160, but titres up to 5120 occurred. No statistically significant correlation was found between the occurrence of high titres of type-specific 0-antibodies to E. coli and evidence of E. coli UTI. In contrast, anti-CA-present in the sera of 19 patients, mostly in titres of 10-40-occured with significantly increased frequency in patients with E. coliuria before transplantation and in patients with growth of E. coli from the nephrectomy specimens. It is concluded that anti-CA-even in low titres-appeared to give a better serological parameter of E. coli UTI than screening for antibodies against the selected uropathogenic E. coli strains.