Relatedness of Escherichia coli colonizing women longitudinally

Purpose: The longitudinal colonization patterns by Escherichia coli of the vaginal introitus and urinary tract were investigated. Materials and Methods: Cultures of the vaginal introitus and midstream urin e were collected once a week for 12 consecutive weeks from five women with (patients) and five without (controls) a history of urinary tract infection (UTI), Results: A total of 63 E. coli isolates was obtained from the 10 women, 26 from controls and 37 from patients. The bacterial counts of E. coli present in control individuals were uniformly low, less than or equal to 200 E. co li/mL. The numbers in patients were higher and more variable, reaching >10( 5)/mL in urine and vaginal specimens. In 16 instances, E. coli was present in the urine and the vaginal introitus concurrently (matched isolates). Ran dom amplified polymorphic DNA (RAPD) fingerprinting was used to characteriz e all matched E. coli isolates. Concurrent vaginal and urinary tract coloni zation was more common in the patient population, and usually, the same E, coli strain was present at both sites; only 15% of the matched isolates rep resented different strains. The RAPD fingerprinting was also carried tout o n selected isolates recovered from four patients and three control individu als over the 12-week study period, Colonization of the vaginal introitus an d urinary tract in these individuals varied over time. Generally, however, a predominant E. coli strain was present in the vaginal milieu, urinary tra ct, or both, either continuously (for as long as 9 consecutive weeks in one patient) or intermittently. Conclusion: The results support the concept that the vaginal mucosa acts as reservoir of E. coli which may enter the urinary tract.