Multiple-Host Sharing, Long-Term Persistence, and Virulence of
            <i>Escherichia coli</i>
            Clones from Human and Animal Household Members

Johnson, James R.; Clabots, Connie; Kuskowski, Michael A.

doi:10.1128/jcm.00980-08

Cited by 129 publications

(121 citation statements)

References 34 publications

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“…As in previous studies (6,7,12,31), shared strains were distributed more broadly, caused more infections, and exhibited more uropathogenic traits than did nonshared strains. This indicates that certain E. coli traits and lineages promote both UTI pathogenesis and intestinal colonization (32).…”

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confidence: 72%

Colonization with Escherichia coli Strains among Female Sex Partners of Men with Febrile Urinary Tract Infection

et al. 2015

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fOf 23 unique Escherichia coli strains from 10 men with febrile urinary tract infections (UTIs) and their female sex partners, 6 strains (all UTI causing) were shared between partners. Molecularly, the 6 shared strains appeared more virulent than the 17 nonshared strains, being associated with phylogenetic group B2, sequence types ST73 and ST127, and multiple specific virulence genes. This indicates that UTIs are sometimes sexually transmitted. Escherichia coli is the leading cause of urinary tract infection (UTI), a tremendously common and costly illness (1). Although the causative E. coli strains usually derive from the host's own gastrointestinal microbiota (2, 3), their more proximate reservoirs are poorly understood.Sharing of E. coli strains, whether pathogenic or not, is common among closely associated hosts, including pets and sex partners (4-19). However, strain sharing between a man with an E. coli UTI and his healthy female sexual partner (FSP) has not been reported. We capitalized on a large cohort of men with E. coli febrile UTIs (FUTIs) to assess this phenomenon's frequency and the characteristics of any shared strains.Subjects and specimens. Ten men with community-acquired E. coli FUTI and an FSP who was willing to participate in the study were identified within a larger cohort study of male FUTI at Sahlgrenska University Hospital, Gothenburg, Sweden, from 1993 to 1996. Men had to have a temperature of Ն 38.0°C, at least one urinary tract-referable symptom or sign (e.g., frequency, dysuria, flank pain, or costovertebral angle tenderness), and Ն10 4 CFU/ml of a uropathogen on urine culture (21,22). Consenting subjects underwent culture surveillance of urine, feces, and (for FSPs) the vagina initially and with any subsequent UTI episode in either partner.Midstream urine samples, collected per protocol, were kept at 4°C until cultured semiquantitatively on blood and cysteine lactose electrolyte-deficient agar. Significant growth was defined as Ն10 4 CFU/ml of E. coli. The last free-lying colony was saved. Men self-collected rectal samples per protocol. One of the authors (P.U.) collected vaginal and rectal samples from FSPs. Swabs were streaked to modified Conradi-Drigalski agar for overnight incubation. The last three free-lying colonies on each plate, plus any morphologically distinct colonies, were picked for analysis; this provided Ն97% sensitivity for detecting the quantitatively predominant clone in rectal samples (23). Confirmed E. coli isolates were stored in agar stabs (24 were assigned based on Ն94% profile similarity to index profiles within a large PFGE database (26).One representative per sample per PFGE type underwent PCRbased major phylogenetic group determination (25). Extended virulence genotypes were determined by multiplex PCR (27-29). Sequence type (ST) and clonal complex (CC; cluster of closely related STs) were determined by PCR (27), fumC-fimH sequence analysis (30), and/or multilocus sequence typing (http: //mlst.warwick.ac.uk).Statistical methods. Comparisons of proportions ...

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confidence: 72%

Colonization with Escherichia coli Strains among Female Sex Partners of Men with Febrile Urinary Tract Infection

et al. 2015

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“…The two most widely shared strains were from group B2 and had extensive virulence genotypes, confirming that group B2 and some of its characteristic virulence genes are associated with prolonged and multiple-host colonization (10,13,24).…”

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confidence: 72%

Sharing of Escherichia coli Sequence Type ST131 and Other Multidrug-Resistant and Urovirulent E. coli Strains among Dogs and Cats within a Household

Miller²,

et al. 2009

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“…One explanation for recurrence is that such a reservoir of UPEC in the gastrointestinal tract of this population of women is reintroduced to the urinary tract, allowing subsequent infections to occur. Indeed, UPEC clones persist long term as commensals within the intestinal tract and can even be shared among family members and household pets (13,24). A diagnostic test that could identify potential carriers of UPEC, therefore, would be beneficial for medical practitioners to determine a course for prevention of recurrent UTI.…”

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Escherichia coli Isolates That Carry vat , fyuA , chuA , and yfcV Efficiently Colonize the Urinary Tract

et al. 2012

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h Extraintestinal Escherichia coli (ExPEC), a heterogeneous group of pathogens, encompasses avian, neonatal meningitis, and uropathogenic E. coli strains. While several virulence factors are associated with ExPEC, there is no core set of virulence factors that can be used to definitively differentiate these pathotypes. Here we describe a multiplex of four virulence factor-encoding genes, yfcV, vat, fyuA, and chuA, highly associated with uropathogenic E. coli strains that can distinguish three groups of E. coli: diarrheagenic and animal-associated E. coli strains, human commensal and avian pathogenic E. coli strains, and uropathogenic and neonatal meningitis E. coli strains. Furthermore, human intestinal isolates that encode all four predictor genes express them during exponential growth in human urine and colonize the bladder in the mouse model of ascending urinary tract infection in higher numbers than human commensal strains that do not encode the four predictor genes (P ‫؍‬ 0.02), suggesting that the presence of the predictors correlates with uropathogenic potential. Extraintestinal pathogenic Escherichia coli (ExPEC), a heterogeneous group of E. coli pathotypes defined by isolation from infections outside the intestinal tract, includes uropathogenic E. coli (UPEC), avian-pathogenic E. coli (APEC), and neonatal meningitis E. coli (NMEC) (20,32). ExPEC strains are a diverse group of pathogenic E. coli strains that cause disease in poultry and companion animals as well as humans (32). While many virulence factors are associated with ExPEC, no core set of virulence factors can unambiguously distinguish the ExPEC subgroups from one another. Therefore, strains can be designated UPEC, APEC, or NMEC only on the basis of the isolation source (20). Unlike diarrheagenic E. coli (DEC) strains, which are obligate intestinal pathogens, ExPEC strains can commensally colonize the human intestine; thus, the intestinal tract can serve as a reservoir for extraintestinal E. coli (20).This ExPEC reservoir is of particular importance for women with recurrent urinary tract infections (UTIs), as UPEC is the predominant cause of uncomplicated UTIs. It is estimated that over 50% of women will have a UTI in their lifetime; 25% will then experience a second UTI and 3% will have a third UTI within 6 months of the initial infection (5). One explanation for recurrence is that such a reservoir of UPEC in the gastrointestinal tract of this population of women is reintroduced to the urinary tract, allowing subsequent infections to occur. Indeed, UPEC clones persist long term as commensals within the intestinal tract and can even be shared among family members and household pets (13,24). A diagnostic test that could identify potential carriers of UPEC, therefore, would be beneficial for medical practitioners to determine a course for prevention of recurrent UTI. Identification of reservoirs of uropathogens could be used to identify at-risk populations and reduce disease transmission. Once carriers of UPEC are identified, the patients can be t...

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Multiple-Host Sharing, Long-Term Persistence, and Virulence of Escherichia coli Clones from Human and Animal Household Members

Cited by 129 publications

References 34 publications

Colonization with Escherichia coli Strains among Female Sex Partners of Men with Febrile Urinary Tract Infection

Colonization with Escherichia coli Strains among Female Sex Partners of Men with Febrile Urinary Tract Infection

Sharing of Escherichia coli Sequence Type ST131 and Other Multidrug-Resistant and Urovirulent E. coli Strains among Dogs and Cats within a Household

Escherichia coli Isolates That Carry vat , fyuA , chuA , and yfcV Efficiently Colonize the Urinary Tract

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