Studies of Introital Colonization in Women with Recurrent Urinary Infections. VII. The Role of Bacterial Adherence

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Abstract
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. An in vitro model was described that measures the capacity of different bacterial species (Escherichia coli and Staphylococcus epidermidis) to adhere to human vaginal epithelial cells. Different bacteria are demonstrated to vary in their adhesive properties. E. coli adhered more readily to vaginal cells from women with recurrent urinary infection than to similar cells from control women resistant to urinary infection (P < 0.001). Biologic susceptibility to recurrent urinary infections in women may be related to a defect at the cellular level that encourages or favors bacterial adherence.