Shiga toxin-producing Escherichia coli (STEC) strains of the O91:H21 serotype have caused severe infections, including hemolytic-uremic syndrome. Strains of the O91 serogroup have been isolated from food, animals, and the environment worldwide but are not well characterized. We used a microarray and other molecular assays to examine 49 serogroup O91 strains (environmental, food, and clinical strains) for their virulence potential and phylogenetic relationships. Most of the isolates were identified to be strains of the O91:H21 and O91:H14 serotypes, with a few O91:H10 strains and one O91:H9 strain being identified. None of the strains had the eae gene, which codes for the intimin adherence protein, and many did not have some of the genetic markers that are common in other STEC strains. The genetic profiles of the strains within each serotype were similar but differed greatly between strains of different serotypes. The genetic profiles of the O91:H21 strains that we tested were identical or nearly identical to those of the clinical O91:H21 strains that have caused severe diseases. Multilocus sequence typing and clustered regularly interspaced short palindromic repeat analyses showed that the O91:H21 strains clustered within the STEC 1 clonal group but the other O91 serotype strains were phylogenetically diverse.IMPORTANCE This study showed that food and environmental O91:H21 strains have similar genotypic profiles and Shiga toxin subtypes and are phylogenetically related to the O91:H21 strains that have caused hemolytic-uremic syndrome, suggesting that these strains may also have the potential to cause severe illness.KEYWORDS STEC, O91, virulence, diversity S higa toxin (Stx) is the main virulence factor of Shiga toxin-producing Escherichia coli (STEC). There are two main Stx types, designated Stx1 and Stx2, and each has many subtypes. However, STEC pathogenesis is complex, and Stx alone, without an adherence factor, is deemed to be insufficient to cause severe diseases like hemorrhagic colitis (HC) and hemolytic-uremic syndrome (HUS) (1, 2). The most common STEC adherence factor is the eae-encoded intimin adhesin, which resides on the locus of enterocyte effacement (LEE) pathogenicity island. However, some STEC strains, such as those of serotypes O91:H21, O113:H21, and others, lack eae but have still caused severe disease (3-5) and so are postulated to have other means for adherence. Genes such as saa, which codes for STEC agglutinating adhesin (6), and sab, which codes for an outer membrane autotransporter protein that enhances biofilm formation (7), have been found in LEE-negative STEC strains and are thought to play a role in adherence.STEC serotype O91:H21 strains are LEE negative but have caused HUS (8, 9). The