Association of the Lewis blood-group phenotype with recurrent urinary tract infections in women Journal Article


Authors: Sheinfeld, J.; Schaeffer, A. J.; Cordon-Cardo, C.; Rogatko, A.; Fair, W. R.
Article Title: Association of the Lewis blood-group phenotype with recurrent urinary tract infections in women
Abstract: Blood-group antigens are found on the surface of urothelial cells and may affect bacterial adherence and thereby the susceptibility to urinary tract infection. We determined the ABO, P, and Lewis blood-group phenotypes in 49 white women with histories of recurrent urinary tract infections and compared them with those found in 49 healthy control women without recurrent urinary tract infections. There was no significant difference between the two groups in the distribution of the ABO or P phenotypes. The distribution of Lewis blood-group phenotypes among control women was similar to that in the general population: secretor phenotype (Le(a-b+)), 74 percent; nonsecretor phenotype (Le(a+b-)), 18 percent; and recessive phenotype (Le(a-b-)), 8 percent. The following distribution was noted among the women with recurrent urinary tract infections: secretor phenotype, 45 percent; nonsecretor phenotype, 29 percent; and recessive phenotype, 26 percent (P = 0.002). When the women with nonsecretor and recessive phenotypes were combined and considered collectively, the odds ratio (an estimate of relative risk of recurrent urinary tract infection) for those without the secretor phenotype was 3.4 (95 percent confidence interval, 1.5 to 7.9). We conclude that there is an increased frequency of the Lewis blood-group nonsecretor (Le(a+b-)) and recessive (Le(a-b-)) phenotypes among women with recurrent urinary tract infections. THE attachment of bacteria to urothelial cells is an important factor in the pathogenesis of urinary tract infections.1 The receptors for uropathogenic organisms, particularly Escherichia coli, are carbohydrate residues located on the surface glycolipids and glycoproteins of urothelial cells.2 The carbohydrate composition of the surface of the urothelial cells is highly variable and influences the availability of these putative receptors to bind bacteria. An important factor in determining the complex-carbohydrate membrane structure of urothelial cells is a person's blood-group profile.2 Blood-group antigens are a group of carbohydrate determinants found on erythrocytes and certain epithelial tissues, including urothelium. The Lewis... © 1989, Massachusetts Medical Society. All rights reserved.
Keywords: adult; clinical article; controlled study; aged; phenotype; urinary tract infection; recurrent disease; blood group lewis system; human; female; priority journal
Journal Title: New England Journal of Medicine
Volume: 320
Issue: 12
ISSN: 0028-4793
Publisher: Massachusetts Medical Society  
Date Published: 1989-03-23
Start Page: 773
End Page: 777
Language: English
DOI: 10.1056/nejm198903233201205
PUBMED: 2922027
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 14 April 2020 -- Source: Scopus
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  1. Joel Sheinfeld
    254 Sheinfeld
  2. William R Fair
    342 Fair
  3. Andre Rogatko
    23 Rogatko