Chapter 6 : Adherence Mechanisms in Urinary Tract Infections

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This chapter provides an overview of the bacterial adhesins that promote colonization of the human urinary tract. Particular attention is addressed to the adherence properties that may contribute to symptomatic urinary tract infection (UTI) in patients with underlying urinary defects including urinary catheterization. Recent progress regarding the adherence properties of bacteria associated with acute community-acquired UTI is also reviewed. Unlike other adhesins discussed in the chapter, type 1 pili are present in most and other members of the family Enterobacteriaceae. However, in the Donovan study, many more people experienced bowel colonization with than experienced symptomatic UTI, so that the net benefit of prophylaxis to eliminate from all patients would have been marginal. As investigators move closer to understanding the structural requirements for recognition and binding of bacterial adhesins to tissue and for the assembly of functional adherence organelles, rational design of novel antiadherence or antiassembly agents will become possible. Little is known about the urinary tract adherence mechanisms of , although it is the primary or secondary cause of UTI in certain patient groups. P pili appear to be a risk factor in the progression of kidney infection to urosepsis. The effectiveness of the test strain for preventing subsequent symptomatic disease is under investigation.

Citation: Hull R, Hull S. 1994. Adherence Mechanisms in Urinary Tract Infections, p 79-90. In Miller V, Kaper J, Portnoy D, Isberg R (ed), Molecular Genetics of Bacterial Pathogenesis. ASM Press, Washington, DC. doi: 10.1128/9781555818340.ch6
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Generic image for table
Table 1

UTI-associated adhesins for which receptors are known

Comprehensive listings of other fimbrial and nonfimbrial adhesins associated with extraintestinal infections can be found in references and .

Families include genetically related adhesins.

Citation: Hull R, Hull S. 1994. Adherence Mechanisms in Urinary Tract Infections, p 79-90. In Miller V, Kaper J, Portnoy D, Isberg R (ed), Molecular Genetics of Bacterial Pathogenesis. ASM Press, Washington, DC. doi: 10.1128/9781555818340.ch6

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