Expression and detection of pap-, sfa-, and afa-encoded fimbrial adhesin systems among uropathogenic Escherichia coli.

Thirty-five Escherichia coli isolates from young children and women with pyelonephritis, cystitis, or asymptomatic bacteriuria were characterized genotypically and phenotypically. The isolates were examined genotypically by using DNA probes specific for the hemolysis gene and for the pap, sfa, and afa adhesin systems. Genes for the adhesin systems were also detected by polymerase chain reaction, using multigene amplification. The isolates were serotyped, tested for hemolysin production, and classified for their adhesion specificity by hemagglutination and by binding specificity assays. Twenty-seven of the 35 isolates were pap positive. Results showed that pap-positive isolates expressing class I or class II G adhesins were more frequent in cases of pyelonephritis than in cases of cystitis and asymptomatic bacteriuria. Expression of the class III G adhesins was more frequent in isolates from cystitis and asymptomatic bacteriuria than in isolates from pyelonephritis. Multiple adhesin systems and hemolysin were more frequently found in isolates from cases of pyelonephritis than in isolates from cases of cystitis and asymptomatic bacteriuria. There was perfect correlation between the results obtained by polymerase chain reaction and and those obtained by hybridization.