Food animals were linked to 17.7% of human clinical urine E. coli isolates among the study population, indicating these as zoonotic ExPEC strains. However, only 0.6% of meat isolates were identified as having a human origin.
Of sequence types, 13% were shared between non-zoonotic ExPEC, zoonotic ExPEC, and meat isolates, though distinct distribution across E. coli groups was reported. The B2 and D phylogroups, significantly linked to extraintestinal pathogenesis, most often presented with non-zoonotic ExPEC isolates.
Antimicrobial resistance profiles and overall conclusions
Significantly varied antimicrobial resistance gene profiles were reported between non-zoonotic ExPEC, zoonotic ExPEC, and meat isolates. While non-zoonotic ExPEC isolates presented with significantly greater multidrug resistance, similar resistance was reported between zoonotic ExPEC and meat isolates.
Isolates from retail chicken had the greatest rate of zoonotic ExPEC-associated sequence types at 38%, followed by turkey at 36%, beef at 14%, and pork at 12%. Clinical isolates often had B2 and D phylogroups, which were rare among meat isolates.
Zoonotic ExPEC strains were more often reported in women than men, at 19.7% and 8.5%, respectively. Overall, the data highlighted zoonotic ExPEC strains as a significant cause of UTIs in Southern California. Investigators concluded interventions are needed to reduce rates of zoonotic ExPEC in processed meet.
“Until such measures are widely adopted, individuals at heightened risk of bacterial infections—including immunocompromised individuals, older adults, and those with chronic conditions—should exercise caution when handling raw meat (including frozen),” wrote investigators.
Emerging treatment options for UTIs
Fortunately, new treatment methods for uncomplicated UTIs are emerging, such as gepotidacin, which was discussed by Ryan Haumschild, PharmD, MS, MBA, CPEL, vice president of pharmacy at Emory Healthcare and Winship Cancer Institute, in a discussion with Contemporary OB/GYN.3
Gepotidacin received FDA approval following positive results from the phase 3 trials EAGLE-2 and EAGLE-3. The data indicated a significant therapeutic success rate of 58.5% vs 43.6% for nitrofurantoin. This provides patients with an alternative option to antibiotics commonly used to manage UTIs.
"Now, when we look at the clinical trial data, it was non-inferior to current available treatment options, which isn't a bad thing... because now it shows that there is equitable data that gives another option," said Haumschild.