The Conundrum of Shiga Toxin-Producing Escherichia coli O157:H7 Persistence: Evidence for Locally Persistent Lineages.

Abstract

Evidence suggests that Shiga toxin-producing Escherichia coli (STEC) strains do not persist at the farm level. We hypothesized that ecosystem-level STEC persistence occurs and contributes significantly to disease burden. We tested this by identifying locally persistent lineages (LPLs) of STEC O157:H7 in Minnesota. We identified 15 distinct LPLs, which were associated with 35.3% of reported cases in Minnesota and persisted for 1.3-8.6 years. Locally persistent lineages were associated with multiple outbreaks with Minnesota sources and no multi-state outbreaks, and LPL cases were spatially clustered. Our findings show long-term persistence in defined geographic areas, suggesting the importance of ecosystem-level persistence.