Foxman Betsy, Manning Shannon D, Tallman Patricia, Bauer Richard, Zhang Lixin, Koopman James S, Gillespie Brenda, Sobel Jack D, Marrs Carl F
Center for Molecular and Clinical Epidemiology, Department of Epidemiology, The University of Michigan School of Public Health, Ann Arbor 48109, USA.
Am J Epidemiol. 2002 Dec 15;156(12):1133-40. doi: 10.1093/aje/kwf159.
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.
由于尿路致病性大肠杆菌比其他大肠杆菌更能适应尿道、尿道周围和阴道,作者推断,尿路致病性大肠杆菌比共生大肠杆菌更有可能在性伴侣之间传播。在这项1996年至1999年于密歇根州开展的研究中,通过脉冲场凝胶电泳确定了从166名患大肠杆菌尿路感染(UTI)的女性、94名未患UTI的女性及其性伴侣身上分离出的大肠杆菌的基因特征。如果直肠分离株在基因上与导致UTI的尿液分离株相同,则被视为尿路致病性大肠杆菌。所有来自患有UTI性伴侣的男性的8份尿液分离株都与其性伴侣尿液或阴道中发现的大肠杆菌相同。当将来自夫妻的550份独特的直肠大肠杆菌分离株作为分析单位时,导致UTI的大肠杆菌在性伴侣之间传播的可能性是其他大肠杆菌的9倍(优势比(OR)= 8.87,95%置信区间(CI):5.41,14.54)。如果大肠杆菌有P菌毛或夫妻进行口交,传播发生的频率会高出两倍(OR = 1.87,95% CI:1.13,3.08)(OR = 2.09,95% CI:1.09,4.00)。与共生大肠杆菌相比,尿路致病性大肠杆菌更有可能与当前的异性性伴侣传播。性行为和一种细菌毒力因子P菌毛都会改变传播情况。