{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T19:27:26Z","timestamp":1771529246909,"version":"3.50.1"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Extraintestinal <jats:italic>Escherichia coli<\/jats:italic> infections represent a growing public health threat, However, current studies often overlook important factors such as temporal patterns of infection, phylogenetic and clonal background, or the host gut <jats:italic>E. coli<\/jats:italic> population, despite their likely significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this study, we analyzed &amp;gt;7000 clinical <jats:italic>E. coli<\/jats:italic> isolates from patients at the Minneapolis Veterans Affairs Health Care System (2012\u20132019), and concurrent fecal <jats:italic>E. coli<\/jats:italic> from uninfected veterans. We assessed phylogenetic group distribution, membership in selected sequence types (STs), and subsets thereof\u2014including the pandemic, resistance-associated ST131-<jats:italic>H<\/jats:italic>30R, and ST1193 lineages\u2014and strain type, as defined by pulsed-field gel electrophoresis. We then analyzed these features alongside the temporal patterns of infection in individual hosts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The <jats:italic>H<\/jats:italic>30R lineage emerged as the leading lineage, both overall and among fluoroquinolone-resistant isolates, with ST1193 following among fluoroquinolone-resistant isolates. Recurrences were common, occurring in 31% of subjects and 41% of episodes, and often multiple and delayed\/prolonged (up to 23 episodes per subject; up to 2655d post-index). Remarkably, these recurrences typically involved the subject\u2019s index strain (63% of recurrences), even when affecting extra-urinary sites. ST131, <jats:italic>H<\/jats:italic>30R, ST1193, and fluoroquinolone-resistant strains generally caused significantly more recurrences than did other strains, despite similar recurrence intervals. ST131 strain types shifted significantly over the study period. Infection-causing strains were commonly detectable in host feces at times other than during an infection episode; the likelihood of detection varied with surveillance intensity and proximity to the infection. <jats:italic>H<\/jats:italic>30R and ST1193 were prominent causes of fecal-clinical clonal overlap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>These findings provide novel insights into the temporal and clonal characteristics of <jats:italic>E. coli<\/jats:italic> infections in veterans and support efforts to develop anti-colonization interventions.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2024.1409272","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T04:21:17Z","timestamp":1717388477000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Longitudinal molecular analysis of clinical and fecal Escherichia coli isolates at a Veterans Affairs Medical Center in Minnesota, USA, 2012\u20132019"],"prefix":"10.3389","volume":"15","author":[{"given":"Connie","family":"Clabots","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Thuras","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James R.","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1136\/sti.65.6.397","article-title":"A case of recurrently sexually transmitted urinary tract infection","volume":"65","author":"Al-Wali","year":"1989","journal-title":"Genitourin. 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