Eco-evolutionary dynamics of Escherichia coli in an island system: Environmental drivers of waterborne urinary tract infections - Project Summary: Water may be an underrecognized but important route of uropathogen transmission causing urinary tract infections (UTls). This realization is supported by recent reports of the presence of uropathogens in water supplies from multiple countries, and our report of a decrease in UTls following installation of a new water treatment plant on San Cristobal Island in Galapagos, Ecuador. Drinking or bathing in contaminated water may expose people to extraintestinal infections caused by Escherichia coli, the most common pathogen associated with UTls. Studies are needed to investigate uropathogenic E. coli in drinking water systems and links to infectious disease. The hypothesis for this work is that waterborne exposures to E. coli are a causative agent of community-acquired UTls, driven by environmental factors and household water use. This hypothesis will be tested in three specific aims: (1) Model the drivers and dynamics of water system E.coli contamination, (2) Identify socio-behavioral, epidemiological, genomic, and ecological factors associated with E. coli UTls and evaluate water as a transmission source, and (3) Estimate the impact of modeled waterborne E. coli exposures at points of use on UTI risk. Results from this work have the potential to revolutionize our understanding of the etiology of UTls and the ecology of uropathogenic E. coli. Models will also inform interventions to improve water quality and prevent disease.
