Bacterial "virulence" Traits and Host Demographics Predict Escherichia coli Colonization Behaviors within Households

Teresa Fox, Connie Clabots, Stephen B. Porter, Tricia Bender, Paul Thuras, Aylin Colpan, Jessica Boettcher, James R Johnson

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Although intestinal colonization precedes most extraintestinal Escherichia coli infections, colonization-promoting factors are incompletely understood. We compared within-household E. coli colonization patterns with host and bacterial traits. Methods: Twenty-two veterans with a clinical E. coli isolate and their 46 human and animal household members underwent longitudinal fecal sampling. Distinct E. coli strains were characterized for phylogenetic background, virulence genes, antibiotic resistance, and colonization behaviors. Host and bacterial traits were assessed statistically as predictors of colonization behaviors. Results: Among the 139 unique-by-household fecal E. coli strains, univariable predictors of colonization behavior included (i) host demographics, (ii) matching the index clinical isolate, and (iii) bacterial characteristics (2 phylogroups, 5 clonal lineages, 18 virulence genes, and molecular extraintestinal pathogenic E. coli status). Multivariable predictors of colonization behavior included veteran host, spouse host, matching the index clinical isolate, phylogroup F, ST73, hlyD (alpha hemolysin), hlyF (variant hemolysin), H7 fliC (flagellar variant), vat (vacuolating toxin), and iha (adhesin-siderophore). Conclusions: Host demographics, multiple bacterial "virulence"traits, and matching the index clinical isolate predicted E. coli fecal colonization behaviors. Thus, certain bacterial characteristics may promote both colonization and pathogenicity. Future interventions directed toward such traits might prevent E. coli infections both directly and by disrupting antecedent colonization.

Original languageEnglish (US)
Article numberofaa495
JournalOpen Forum Infectious Diseases
Issue number11
StatePublished - Nov 1 2020

Bibliographical note

Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.


  • Escherichia coli
  • ST131-H30
  • intestinal colonization
  • strain sharing
  • virulence factors


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