Pediatric urinary tract infections caused by poultry-associated Escherichia coli

Maliha Aziz, Gregg Davis, Dan Park, Azza Idris, Sanjeev Sariya, Yashan Wang, Sara Zerbonne, Lora Nordstrom, Brett Weaver, Sally Statham, Timothy Johnson, Joseph Campos, Eduardo Castro-Nallar, Keith Crandall, Zhenke Wu, Cindy Liu, Roberta DeBiasi, Lance Price (2024). Microbiology Spectrum
DOI
10.1128/spectrum.03415-23
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Abstract

Escherichia coli is the leading cause of urinary tract infections (UTIs) in children and adults. The gastrointestinal tract is the primary reservoir of uropathogenic E. coli, which can be acquired from a variety of environmental exposures, including retail meat. In the current study, we used a novel statistical-genomic approach to estimate the proportion of pediatric UTIs caused by foodborne zoonotic E. coli strains. E. coli urine isolates were collected from DC residents aged 2 months to 17 years from the Children’s National Medical Center laboratory, 2013-2014. During the same period, E. coli isolates were collected from retail poultry products purchased from 15 sites throughout DC. A total of 52 urine and 56 poultry isolates underwent whole-genome sequencing, core genome phylogenetic analysis, and host origin prediction by a Bayesian latent class model that incorporated data on the presence of mobile genetic elements (MGEs) among E. coli isolates from multiple vertebrate hosts. A total of 56 multilocus sequence types were identified among the isolates. Five sequence types – ST10, ST38, ST69, ST117 and ST131 – were observed among both urine and poultry isolates. Using the Bayesian latent class model, we estimated that 19% (10/52) of the clinical E. coli isolates in our population were foodborne zoonotic strains. These data suggest that a substantial portion of pediatric UTIs in the Washington DC region may be caused by E. coli strains originating in food animals and likely transmitted via contaminated poultry meat.

Importance

  • Escherichia coli is a leading cause of urinary tract infections (UTIs), one of the most common bacterial infections of childhood.
  • We applied a novel statistical-genomic approach to identify pediatric UTI isolates originating from food-animal sources.
  • Our study suggests that approximately 19% of UTIs in our pediatric population were caused by E. coli strains originating from poultry.

Keywords poultry, pediatric, urinary tract infection, foodborne, Escherichia coli, Bayesian latent class model, zoonotic infections