# Gut reservoir of E. coli ST131

> **NIH VA I01** · MINNEAPOLIS VA  MEDICAL CENTER · 2021 · —

## Abstract

A new Escherichia coli strain called ST131-H30 – unknown prior to 2000 – is now the single most common
cause of E. coli infections such as urinary tract infections, particularly those associated with resistance to first-
line antibiotics. Veterans are especially vulnerable to ST131-H30, which causes 25-30% of all their E. coli
infections, and 70-75% of those involving fluoroquinolone (e.g., ciprofloxacin) resistance. Gut colonization is an
important upstream step in ST131-H30 infections, and therefore is a key part of the ST131-H30 epidemic. We
have found that, in veterans and their household members, gut colonization with fluoroquinolone-resistant E.
coli (12-13% overall) is quite prolonged (possibly years), is significantly longer for ST131-H30 than other
resistant E. coli, and is attributable more to strain persistence than frequent transmission. This suggests the
possibility of reducing gut colonization with ST131-H30 by identifying modifiable risk factors, host immune
factors, bacterial traits, and characteristics of the gut microbiota that correlate with prolonged H30 colonization
and loss of colonization, to inform the development of appropriate interventions. Accordingly, we propose to
augment our current longitudinal fecal surveillance of H30-colonized veterans and household members by:
 · identifying epidemiological risk factors for presence and loss of H30 colonization
 · identifying humoral and cell-mediated immune correlates of presence and loss of H30 colonization
 · identifying genomic differences between initial vs. final, and shorter vs. longer-persisting, fecal ST131-
 H30 isolates
· identifying shifts in the gut microbiota (i.e., bacterial community and E. coli population) that correspond
 with presence and loss of H30 colonization.
The results of these studies can be expected to provide essential information needed for the design of
interventions (e.g., risk factor modification, vaccines, anti-colonization drugs, and pre- or probiotics) to reduce
gut colonization with the ST131-H30 strains that cause infections in veterans. Such interventions should help
to reduce the enormous disease burden from infections caused by multi-resistant E. coli, mainly ST131-H30.

## Key facts

- **NIH application ID:** 9892970
- **Project number:** 5I01CX000920-07
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** JAMES R JOHNSON
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2014-01-01 → 2021-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9892970

## Citation

> US National Institutes of Health, RePORTER application 9892970, Gut reservoir of E. coli ST131 (5I01CX000920-07). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9892970. Licensed CC0.

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