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Whole-genome sequencing was conducted on E. coli originating from the bloodstream to characterize sequence types (STs), serotypes, and theoretical coverage of a 9-valent ExPEC polysaccharide conjugate vaccine (ExPEC9V). Separately, we evaluated 601 E. coli whole-genome sequences from humans, animals, and environmental sources in nearby communities. We assessed genetic relatedness between bloodstream and community isolates based on single-nucleotide polymorphisms and allele differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Of 3046 participants receiving blood culture, 48 (0.2%) had BSI yielding 48 E. coli isolates. The median (range) age of participants with E. coli BSI was 40.7 (0.3\u201389.0) years, and 32 (68.1%) were female. We identified 16 STs including ST131 (n = 16, 33.3%), ST73 (n = 10, 20.8%), and ST69 (n = 6, 12.5%) and 19 O groups including O25 (n = 13, 27.1%), O6 (n = 10, 20.3%), O17 (n = 4, 8.3%), and O18 (n = 4, 8.3%). Theoretical coverage for an ExPEC9V was 72.9%. None of the bloodstream and community E. coli pairs were closely related.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found a high diversity of STs among E. coli human bloodstream isolates in Tanzania. Despite this diversity, we observed that an EXPEC9V in development would provide good coverage. Reservoir-attribution studies at finer spatial and temporal scales may better identify transmission networks and reservoirs of ExPECs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf437","type":"journal-article","created":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T11:27:34Z","timestamp":1755343654000},"page":"112-121","source":"Crossref","is-referenced-by-count":2,"title":["Population Structure of\n                    <i>Escherichia coli<\/i>\n                    Isolated From the Human Bloodstream, Human and Animal Feces, and the Environment in Northern Tanzania"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4023-3928","authenticated-orcid":false,"given":"Deng B","family":"Madut","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and International Health, Duke University , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5262-1421","authenticated-orcid":false,"given":"Matthew P","family":"Rubach","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Duke University , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3931-4846","authenticated-orcid":false,"given":"Flemming","family":"Scheutz","sequence":"additional","affiliation":[{"name":"International Centre for Reference and Research on Escherichia and Klebsiella, Statens Serum Institut , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas R","family":"Call","sequence":"additional","affiliation":[{"name":"Paul G. Allen School for Global Health, College of Veterinary Medicine, Washington State University , Pullman, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdoos A","family":"Gogry","sequence":"additional","affiliation":[{"name":"Paul G. Allen School for Global Health, College of Veterinary Medicine, Washington State University , Pullman, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-5905","authenticated-orcid":false,"given":"Manuela","family":"Carugati","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Duke University , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Kalengo","sequence":"additional","affiliation":[{"name":"Kilimanjaro Christian Medical Centre , Moshi ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Marandu","sequence":"additional","affiliation":[{"name":"Mawenzi Regional Referral Hospital , Moshi ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8909-1508","authenticated-orcid":false,"given":"Michael J","family":"Maze","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Otago , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B","family":"Morrissey","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, Duke University , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2909-9705","authenticated-orcid":false,"given":"Bingileki F","family":"Lwezaula","sequence":"additional","affiliation":[{"name":"Mawenzi Regional Referral Hospital , Moshi ,","place":["Tanzania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blandina 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