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Am J Epidemiol 2002; 156:1133-1140.
Copyright © 2002 by Johns Hopkins Bloomberg School of Public Health


ORIGINAL CONTRIBUTIONS

Uropathogenic Escherichia coli Are More Likely than Commensal E. coli to Be Shared between Heterosexual Sex Partners

Betsy Foxman1,, Shannon D. Manning1, Patricia Tallman1, Richard Bauer1, Lixin Zhang1, James S. Koopman1, Brenda Gillespie2, Jack D. Sobel3 and Carl F. Marrs1

1 Center for Molecular and Clinical Epidemiology, Department of Epidemiology, The University of Michigan School of Public Health, Ann Arbor, MI.
2 Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI.
3 Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI.

Because uropathogenic Escherichia coli are better adapted than other E. coli to the urethra, periurethra, and vagina, the authors reasoned that uropathogenic E. coli would be more likely than commensal E. coli to be shared between sex partners. In this 1996–1999 Michigan study, the genetic identity of E. coli isolated from 166 women with E. coli urinary tract infection (UTI) and 94 women without UTI and their sex partners was determined by pulsed-field gel electrophoresis. Rectal isolates were considered uropathogenic E. coli if genetically identical to the urinary isolate causing UTI. All eight urinary isolates from men with UTI partners were identical to the E. coli found in the urine or vagina of their sex partner. When the 550 unique rectal E. coli isolates from couples were considered the unit of analysis, E. coli that caused UTI were nine times (odds ratio (OR) = 8.87, 95% confidence interval (CI): 5.41, 14.54) more likely than other E. coli to be shared between sex partners. Sharing occurred twice as frequently (OR = 1.87, 95% CI: 1.13, 3.08) if the E. coli had P pili or if the couples engaged in oral sex (OR = 2.09, 95% CI: 1.09, 4.00). Uropathogenic E. coli are more likely than commensal E. coli to be shared with a current heterosexual sex partner. Both sexual behaviors and a bacterial virulence factor, P pili, modified sharing.

disease transmission; Escherichia coli; sexual partners; urinary tract infections

Abbreviations: Abbreviations: cfu, colony-forming unit; CI, confidence interval; OR, odds ratio; PFGE, pulsed-field gel electrophoresis; UTI, urinary tract infection.


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