Most (greater than 90%) Escherichia coli strains isolated from children with acute non-obstructive pyelonephritis exhibit a specific type of filamentous protein appendage known as P-fimbriae. These fimbriae enable the bacterium to adhere to human uroepithelial cells by the specific recognition of and binding to a particular class of glycosphingolipids correlated to the human P-blood group antigens. In this paper a new method for the rapid and reliable identification of such P-fimbriated pyelonephritogenic bacteria is described. The method is based on particles to which the minimal glycoside receptor structure recognized by P-fimbriae is attached. Mixing these receptor-containing particles with P-fimbriated bacteria results in a strong and immediate agglutination reaction. The specificity and sensitivity of this new particle agglutination test proved to be superior to the haemagglutination assay previously used.
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