Bacterial adherence and immune response in recurrent urinary tract infection

Objective: To study the significance of bacterial adherence and humoral immune response in the pathogenesis of recurrent urinary tract infection in adult women. Methods: The study population consisted of 30 women with recurrent urinary tract infection (UTI) and 30 healthy women as controls. Bacterial adherence to vaginal epithelial cells was studied. The concentration of serum and urine antibodies against mixed coliform antigen and clinical isolate was determined by enzyme-linked immunosorbant assay (ELISA). The surface hydrophobicity of the organisms was determined. Student's unpaired t-test and Pearson's correlation coefficient test were used in the statistical analysis. Results: There was an increased adherence of bacteria to vaginal epithelial cells of women with recurrent UTI. The SIgA level in urine was low compared with other antibodies. There was good correlation between the level of free urinary IgG antibody and bacterial adherence. Conclusions: This study showed that increased receptivity of vaginal epithelial cells to pathogens and lower local immunity may play an important role in the pathogenesis of recurrent UTI in females.