Escherichia coli K1, the most common cause of meningitis in neonates, has been shown to interact with GlcNAc1-4GlcNAc epitopes of Ecgp96 on human brain microvascular endothelial cells (HBMECs) via OmpA (outer membrane protein A). However, the precise domains of extracellular loops of OmpA interacting with the chitobiose epitopes have not been elucidated. We report the loop-barrel model of these OmpA interactions with the carbohydrate moieties of Ecgp96 predicted from molecular modeling. To test this model experimentally, we generated E. coli K1 strains expressing OmpA with mutations of residues predicted to be critical for interaction with the HBMEC and tested E. coli invasion efficiency. For these same mutations, we predicted the interaction free energies (including explicit calculation of the entropy) from molecular dynamics (MD), finding excellent correlation (R 2 ؍ 90%) with experimental invasion efficiency. Particularly important is that mutating specific residues in loops 1, 2, and 4 to alanines resulted in significant inhibition of E. coli K1 invasion in HBMECs, which is consistent with the complete lack of binding found in the MD simulations for these two cases. These studies suggest that inhibition of the interactions of these residues of Loop 1, 2, and 4 with Ecgp96 could provide a therapeutic strategy to prevent neonatal meningitis due to E. coli K1.Neonatal bacterial meningitis is one of the most serious infections of the central nervous system, resulting in significant neurological sequelae (such as hearing loss, convulsive disorders, abnormal speech patterns, cortical blindness, and mental retardation) in half of the survivors (1-4). The incidence of bacterial meningitis in infants is about five cases per 100,000 live births per year in developed countries but can be 10 times higher in underdeveloped countries (5).Escherichia coli K1 is the predominant pathogen causing neonatal meningitis and septicemia (6). The mortality and morbidity due to E. coli K1 has remained significant in the last few decades, despite the use of effective antimicrobial therapy. This poor outcome is due to increased antibiotic resistance of E. coli, possibly due to their use in food stock (7) and the high adaptive mutation ability of E. coli (shown to be on the order of 10 Ϫ5 per genome per generation) (8).Our previous experimental studies in the newborn rat model of hematogenous meningitis demonstrated that a high degree of bacteremia is required for the onset of meningitis (9). We showed that the entry of E. coli K1 into human brain microvascular endothelial cells (HBMEC), 3 which comprise the lining of the blood-brain barrier, requires the expression of a 35-kDa OmpA (outer membrane protein A) in E. coli K1 (10).In addition, we and others (9 -12) showed that OmpA expression is important for entry of monocytes, macrophages, and dendritic cells, indicating the important role of this protein in the pathogenesis of neonatal meningitis by E. coli K1. We also showed that the interaction of OmpA with Ecgp96 (a homologue of Hs...