The adhesion of Escherichia coli to host epithelial cells is the very first step of urinary tract infections followed by the internalization of some bacteria into these cells. These steps are influenced by several surface antigens or products of the pathogen, e.g. fimbriae or adhesins, K antigen, and hemolysin. The bacterial adherence and the internalization of several mutants of an E. coli O18:K5 strain differing in the expression of K5 antigen, hemolysin, and fimbriae were measured using a permanent line of porcine tubuloepithelial cells (LLC-PK1). Strains with K5 antigen were reduced in adherence and internalization in comparison to the K-negative strains. The expression of hemolysin by these strains lead to an increase of adherence and internalization. The internalization of bacteria is influenced mainly by their adherence to the epithelial cells. Thus, the internalization of attached bacteria is rather a kind of endocytosis than an invasion of the bacteria. To confirm this thesis, we investigated the influence of cytoskeletal inhibitors (cytochalasine B, cytochalasine D, colchicine, and chloroquine) on bacterial adherence and internalization. The cytoskeletal inhibitors lead to a significant inhibition of internalization of the bacteria tested. The receptor-mediated endocytosis of bacteria by tubuloepithelial cells may be of importance in the pathogenesis of recurrent urinary tract infection.