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Infect Immun, July 1998, p. 3303-3310, Vol. 66, No. 7
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
In Vivo Phase Variation of Escherichia
coli Type 1 Fimbrial Genes in Women with Urinary Tract
Infection
Jean K.
Lim,1
Nereus W.
Gunther IV,1
Hui
Zhao,1
David E.
Johnson,2
Susan K.
Keay,2 and
Harry L. T.
Mobley1,*
Department of Microbiology and
Immunology1 and
Division of Infectious
Diseases,2 University of Maryland School of
Medicine, Baltimore, Maryland 21201
Received 30 December 1997/Returned for modification 25 February
1998/Accepted 21 April 1998
Type 1 fimbriae, expressed by most Escherichia coli
strains, are thought to attach to human uroepithelium as an initial
step in the pathogenesis of urinary tract infections (UTI). Numerous reports using both in vitro and murine models support this role for
type 1 fimbriae in colonization. Unfortunately, only a limited number
of studies have directly examined the expression of fimbriae in vivo.
To determine whether type 1 fimbrial genes are transcribed during an
acute UTI, we employed a modification of an established method. The
orientation (ON or OFF) of the invertible promoter element, which
drives transcription of type 1 fimbrial genes, was determined by PCR
amplification using primers that flank the invertible element, followed
by SnaBI digestion. The orientation of the type 1 fimbrial
switch was determined under three experimental conditions. First,
E. coli strains from different clinical sources (acute
pyelonephritis patients, cystitis patients, and fecal controls) were
tested under different in vitro culture conditions (agar versus broth;
aerated versus static). The genes in the more-virulent strains (those
causing acute pyelonephritis) demonstrated a resistance, in aerated
broth, to switching from OFF to ON, while those in fecal strains
readily switched from OFF to ON. Second, bladder and kidney tissue from
CBA mice transurethrally inoculated with E. coli CFT073 (an
established murine model of ascending UTI) was assayed. The switches
directly amplified from infected bladder and kidney tissues were
estimated to be 33 and 39% ON, respectively, by using a standard
curve. Finally, bacteria present in urine samples collected from women
with cystitis were tested for type 1 fimbria switch orientation. For
all 11 cases, an average of only 4% of the switches in the bacteria in
the urine were ON. In 7 of the 11 cases, we found that all of the
visible type 1 fimbrial switches were in the OFF position (upper limit
of detection of assay, 98% OFF). Strains recovered from these urine
samples, however, were shown after culture in vitro to be capable of
switching the fimbrial gene to the ON position and expressing
mannose-sensitive hemagglutinin. The results from experimental
infections and cases of cystitis in women suggest that type 1 fimbrial
genes are transcribed both in the bladder and in the kidney. However,
those bacteria found in the urine and not attached to the uroepithelium
are not transcriptionally active for type 1 fimbrial genes.
*
Corresponding author. Mailing address: Department of
Microbiology and Immunology, University of Maryland School of Medicine, 655 W. Baltimore St., Baltimore, MD 21201. Phone: (410) 706-0466. Fax:
(410) 706-6751. E-mail: hmobley{at}umaryland.edu.
Infect Immun, July 1998, p. 3303-3310, Vol. 66, No. 7
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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