Urinary tract infection (UTI) commonly occurs among young, otherwise healthy women in their sexually active years, and accounts for 3% of all physician visits in this group. Our overall goal is to demonstrate that UTI can be transmitted between sex partners, and that transmittable uropathogens are associated with unique, identifiable characteristics. We will identify behavioral and bacterial factors associated with transmission of UTI, by comparing the degree of concordance of urinary isolates from 500 women with UTI and the urethral flora of their male sex partners to the degree of concordance amont 500 controls and their sex partners by the presence of behavioral characteristics and for E. coli, virulence signatures. By comparing the virulence signatures of paired E. coli urinary isolates to fecal isolates from UTI cases, and comparing virulence signatures from E. coli isolates from UTI cases to isolates form controls, we will be able to identify factors characteristic of uropathogens. Specifically we plan to:
Aim 1. Demonstrate heterosexual transmission of uropathogens.
Aim 2. Identify bacterial virulence characteristics associated with transmission of E. coli between partners.
Aim 3. Identify bacterial virulence characteristics associated with the development of UTI, by comparing the virulence signatures of E. coli from the urine of women with UTI to virulence signatures o E. coli from their fecal flora, E. coli from their sex partners' urine E. coli from the urine or vagina of controls, and E. Coli from the urine of sex partners of controls. The identification of heterosexually transmitted UTI and the distinct characteristics of uropathogens has implication for prevention, treatment, and understanding of the epidemiology of all UTI. These include vaccine development, treatment of sex partners, and increased ability to detect preventable risk factors.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK035368-09
Application #
2608401
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Project Start
1986-07-01
Project End
2000-11-30
Budget Start
1997-12-01
Budget End
1998-11-30
Support Year
9
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
791277940
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Marrs, Carl F; Zhang, Lixin; Foxman, Betsy (2005) Escherichia coli mediated urinary tract infections: are there distinct uropathogenic E. coli (UPEC) pathotypes? FEMS Microbiol Lett 252:183-90
Sison, Jennette D; Gillespie, Brenda; Foxman, Betsy (2004) Consistency of self-reported sexual behavior and condom use among current sex partners. Sex Transm Dis 31:278-82
Zhang, Lixin; Foxman, Betsy (2003) Molecular epidemiology of Escherichia coli mediated urinary tract infections. Front Biosci 8:e235-44
Zhang, Lixin; Foxman, Betsy; Marrs, Carl (2002) Both urinary and rectal Escherichia coli isolates are dominated by strains of phylogenetic group B2. J Clin Microbiol 40:3951-5
Foxman, Betsy; Manning, Shannon D; Tallman, Patricia et al. (2002) Uropathogenic Escherichia coli are more likely than commensal E. coli to be shared between heterosexual sex partners. Am J Epidemiol 156:1133-40
Howell, Amy B; Foxman, Betsy (2002) Cranberry juice and adhesion of antibiotic-resistant uropathogens. JAMA 287:3082-3
Bauer, Richard J; Zhang, Lixin; Foxman, Betsy et al. (2002) Molecular epidemiology of 3 putative virulence genes for Escherichia coli urinary tract infection-usp, iha, and iroN(E. coli). J Infect Dis 185:1521-4
Geiger, A M; Foxman, B (1996) Risk factors for vulvovaginal candidiasis: a case-control study among university students. Epidemiology 7:182-7
Geiger, A M; Foxman, B; Gillespie, B W (1995) The epidemiology of vulvovaginal candidiasis among university students. Am J Public Health 85:1146-8