Escherichia coli sequence type 131: Epidemiology and challenges in treatment

Zubair A. Qureshi, Yohei Doi

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)


Escherichia coli ST131 has emerged as a global epidemic, multidrug-resistant clone of E. coli causing extra-intestinal infections. It is now highly prevalent among fluoroquinolone-resistant and CTX-M ESBL-producing E. coli isolates worldwide. Humans are likely the primary reservoir of ST131. Factors associated with its acquisition include residence in long-term care facilities and recent receipt of antimicrobial agents. E. coli ST131 causes a wide array of infections ranging from cystitis to life-threatening sepsis. Fluoroquinolones and trimethoprim-sulfamethoxazole are no longer adequate options for empiric therapy when E. coli ST131 is suspected from risk factors and local epidemiology. Expanded-spectrum cephalosporins, piperacillin- tazobactam and carbapenems are options to treat serious non-ESBL-producing E. coli ST131 infections, while carbapenems are indicated for ESBL-producing infections. There is a growing interest in reevaluating oral agents including fosfomycin and pivmecillinam for less serious infections such as uncomplicated cystitis.

Original languageEnglish
Pages (from-to)597-609
Number of pages13
JournalExpert Review of Anti-Infective Therapy
Issue number5
Publication statusPublished - 05-2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology


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