Pediatric urinary tract infections from poultry-associated Escherichia coli

Escherichia coli is the leading cause of urinary tract infection, one of the most common bacterial infections of childhood. The gastrointestinal tract is the primary reservoir of extraintestinal pathogenic E. coli, which are acquired from a variety of environmental exposures, including food. In the current study, we compared E. coli isolates from retail poultry and those from pediatric urinary tract infections.E. coli urine isolates were collected from DC residents aged 2 months to 17 years at the Children's National Medical Center clinical laboratory. Poultry E. coli were isolated from retail chicken and turkey products purchased from 15 sites throughout the District of Columbia. All isolates were subjected to whole-genome sequencing. Genetic relatedness was assessed using multilocus-sequence typing (MLST) and core-genome phylogenetic analyses. Isolates were also screened for avian-associated ColV plasmids in silico.There were 56 MLST sequence types among the 108 E. coli isolates sequenced in this study. Poultry isolates were twice as diverse as UTI isolates (40 poultry: 21 UTI sequence types), and five sequence types were shared between both populations. Phylogenetic analyses revealed close evolutionary relationships among some poultry and UTI E. coli isolates, and ColV plasmids were detected in 42 isolates from poultry and 11 from pediatric UTIs.Our results suggest that approximately 20% of pediatric UTIs are attributable to poultry-associated E. coli. The burden of pediatric UTIs may be reduced by improving hand and kitchen hygiene and reducing extraintestinal pathogenic E. coli contamination on poultry products.