Escherichia coli strains 444-3 and 469-3, isolated from patients with severe infantile enteritis, are able to adhere to and penetrate human epithelial cells in culture. In addition to type 1 fimbriae and glycocalyces, both strains elaborate mannose-resistant nonfimbrial protein hemagglutinins specific for human erythrocytes. Purified agglutinins are aggregates (greater than 4 x 106 daltons) of a single protein subunit of apparent M, 14,000 (469-3) to 14,500 (444-3). The optimal temperature for expression of the agglutinins is 37°C. Bacteria grown at 22°C, which show 1% or less of maximal activity, and mutants deficient in the ability to agglutinate human erythrocytes do not synthesize detectable levels of these surface proteins and, moreover, do not adhere to cultured epithelial cells. Coupled with the observation that purified agglutinins competitively inhibit bacterial adherence to cultured cells, these data indicate that the nonfimbrial surface proteins expressed by strains 444-3 and 469-3 are essential for adherence both to erythrocytes and to cultured epithelial cells.