Environmental alteration and two distinct mechanisms of E. coli adherence to bladder epithelial cells.

We used an in vitro model to investigate Escherichia coli attachment to transitional epithelial cells obtained from bladders of female rats. Adhesive abilities and sensitivity to mannose inhibition differed among the isolates for both epithelial cells and erythrocytes. Adherence of some strains could be modulated by bacterial washes and growth media. Variations in adhesiveness were related to bacterial piliation as determined by transmission electron microscopy. With two strains, mannose inhibition of adherence to epithelial cells was dose-related; however, with a maximal inhibitory dose, adherence was reduced by approximately 80 per cent even when the bacteria-to-epithelial cell ratio was varied. These studies show that adhesiveness and piliation of certain adhesive E. coli strains are either reduced or enhanced by environmental alterations. We conclude that E. coli strains adhere to epithelial cells by at least two distinct mechanisms and that a single isolate may utilize both mechanisms. The more efficient process is pili-mediated and inhibited by mannose whereas undetermined surface components mediate the less efficient but mannose-resistant mechanism.