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Transmission dynamics of Escherichia coli sequence type 131 in households—a one health prospective cohort study

Author

Listed:
  • Rebecca Lynn Perez

    (National University of Singapore)

  • Hao Chung The

    (National University of Singapore
    Oxford University Clinical Research Unit)

  • Kithalakshmi Vignesvaran

    (National University Hospital
    National University of Singapore)

  • Wei Cong Tan

    (National University Hospital
    National University of Singapore)

  • Melissa Sin Hui Chua

    (National University Hospital)

  • En Ying Tan

    (National University Hospital)

  • Si Yu Peng

    (National University Hospital)

  • Lingyue Zhou

    (National University Hospital)

  • Shweta Rajkumar Singh

    (National University of Singapore)

  • Wesley Yeung

    (National University Hospital
    National University Hospital Singapore)

  • Ivan Seah

    (National University Hospital)

  • Jeanette Teo

    (National University Hospital)

  • Kyaw Thu Aung

    (National Environment Agency
    Singapore Food Agency
    Nanyang Technological University
    National University of Singapore)

  • Cheng Yee Tang

    (National University of Singapore)

  • Rick Twee-Hee Ong

    (National University of Singapore)

  • Ben S. Cooper

    (University of Oxford)

  • Ritu Banerjee

    (Vanderbilt University)

  • Paul Anantharajah Tambyah

    (National University Hospital
    National University of Singapore
    National University of Singapore)

  • Yin Mo

    (National University of Singapore
    National University Hospital
    National University of Singapore
    National University of Singapore)

Abstract

Escherichia coli sequence type 131 (ST131) is a major cause of community-onset, multidrug-resistant extraintestinal infections. The transmission and carriage dynamics associated with E. coli ST131’s global prevalence remain poorly understood. Here, we identify a group of persistent, high-density carriers of E. coli ST131 in the community. In this prospective cohort study in Singapore, we enrolled index patients with prior extraintestinal E. coli infections (17 with ST131, 17 with other sequence types) and their household coresidents. We collected sequential stool samples from 135 human participants and six companion animals and environmental swabs from 34 households. We identified nine carriers that persistently carried E. coli ST131 in high densities (57.79% of E. coli isolates per sample) for a median carriage duration of 86.35 days (80% credible interval (CrI) 30.03 to 188.80). Persistent carriers and their coresidents carried genetically similar E. coli ST131 isolates (median single nucleotide polymorphism distance 2, interquartile range 2 to 7), but persistent carriers harboured greater diversity, suggesting that they were the source of inter-individual transmissions. Our results highlight asymptomatic, persistent carriers as potential reservoirs sustaining community E. coli ST131 transmissions, offering a potential target for public health interventions such as vaccination to limit the spread of multidrug resistance.

Suggested Citation

  • Rebecca Lynn Perez & Hao Chung The & Kithalakshmi Vignesvaran & Wei Cong Tan & Melissa Sin Hui Chua & En Ying Tan & Si Yu Peng & Lingyue Zhou & Shweta Rajkumar Singh & Wesley Yeung & Ivan Seah & Jeane, 2025. "Transmission dynamics of Escherichia coli sequence type 131 in households—a one health prospective cohort study," Nature Communications, Nature, vol. 16(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-63121-x
    DOI: 10.1038/s41467-025-63121-x
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    1. Jackson, Christopher, 2011. "Multi-State Models for Panel Data: The msm Package for R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 38(i08).
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