A 72-year-old homosexual man experienced frequent recurrences of symptomatic urinary tract infection (UTI) putatively due to the same strain of extraintestinal pathogenic Escherichia coli, despite receiving repeated courses of seemingly appropriate antibiotic therapy. Both the patient and his male sex partner were found to have fecal colonization with the strain recovered from the patient's urine, which exhibited characteristics of the E. coli O1/O2:K1:H7 clonal group (which is associated with urosepsis), whereas genetically distinct E. coli strains were recovered from a jar of petroleum jelly used by the couple during sexual activity.