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[The virulence factor of E. coli in genitourinary tract infections. 2. Detection of P fimbriae and its role in genitourinary tract infections].

A new method, globoside-incorporated liposome agglutinaiton, which identifies P-fimbriated E. coli, was designed. This method was applied to E. coli isolated from patients with acute uncomplicated pyelonephritis (AUP, 47 strains), acute bacterial prostatitis (ABP, 24 strains) and acute uncomplicated cystitis (AUC, 183 strains) and the results were compared with haemagglutination and other bacterial properties. Globoside-incorporated liposome agglutination proved to be a useful method for the identification of P-fimbriated E. coli. The incidence of P fimbriae in E. coli isolated from patients with AUP, ABP and AUC and in E. coli from the faecal samples of healthy individuals was 48.9%, 12.5%, 22.5% and 10.0%, respectively. Although the percentage was high among patients with AUP, the incidence of P f imbriae in genitourinary tract infections in general was relatively low. In contrast, the incidence of MR fimbriae (mediate mannose resistant haemagglutination, including P fimbriae) and type 1 fimbriae in genitourinary tract infections was 74.8% and 88.2%, respectively. Among cases of AUP, ABP and AUC and in faecal samples, the respective percentages of E. coli having both MR and type 1 fimbriae were 70.2%, 75.0%, 66.1% and 18.6%. Consequently, simultaneous presence of MR (including P) and type 1 fimbriae might be the most significant virulence factor in genitourinary tract infections.