E. coli ST131 drives community multidrug-resistant extraintestinal infection. A prospective Singapore household cohort enrolled 17 prior ST131 and 17 other E. coli index patients plus coresidents, with serial stool from 135 people, six pets and environmental swabs from 34 households. Nine persistent high-density carriers had ST131 comprising 57.79% of E. coli isolates and median carriage of 86.35 days. Carrier and coresident isolates were a median two SNPs apart, and carriers had greater diversity, suggesting potential reservoir and source roles.
Key findings
- Nine persistent carriers; ST131 57.79% per sample; median carriage 86.35 days (80% CrI 30.03-188.80); household median two SNPs (IQR 2-7); higher carrier diversity suggested source.
Why this matters globally
Identifying persistent carriers may enable vaccination, hygiene or decolonization trials targeting reservoirs rather than infections alone, with One Health sampling spanning people, animals and environments.
Thai researcher contribution
Yin Mo is affiliated with MORU, linking Thailand-based networks to Asian genomic epidemiology and antimicrobial resistance.
Limitations to consider
Thirty-four households and nine carriers yield uncertainty. Prior-infection selection limits community generalization. Diversity supports but does not prove direction, intervals may miss events, and antibiotics, diet and contacts confound. Vaccination is an implication, not tested here.