Binding to galactose alpha 1----4galactose beta-containing receptors as potential diagnostic tool in urinary tract infection.

The diagnosis of urinary tract infection is based largely on quantitative urine cultures. The usefulness of qualitative information about the virulence of the infecting bacteria remains undefined. Ability to attach to human uroepithelial cells is one characteristic of the pyelonephritogenic clones, as well as a virulence factor per se. The identification of host cell receptors for attaching bacteria has permitted the construction of agglutination tests for simple detection of bacterial binding properties. In the present study, the reactivity with Gal alpha 1----4Gal beta-latex [galactose alpha (1----4)galactose beta-latex] and globotetraosylceramide-latex was analyzed for strains from patients with acute pyelonephritis (n = 135), acute cystitis (n = 121), and asymptomatic bacteriuria (n = 119) and from the fecal flora of healthy children (n = 120) and compared with agglutination of human blood group P1 and p, as well as guinea pig, erythrocytes. The reactivity by bioassay and the receptor-specific assays were significantly correlated. The frequency of positive reactions among the pyelonephritis isolates was 78.5% with the globotetraosylceramide-latex reagent, compared with 41% for the cystitis isolates, 25% for the asymptomatic bacteriuria isolates, and 13% for the fecal isolates. The combination of bioassays and receptor-specific assays increased the resolution of adhesins. Thus, adhesins reacting with human p erythrocytes frequently were coexpressed with Gal alpha 1----4Gal beta-specific adhesins. The receptor-specific assays provide a refined reagent to resolve bacterial binding specificities, as well as a potential tool for clinical diagnosis.