1. Clinical course and the role of shiga toxin-producing Escherichia coli infection in the hemolytic-uremic syndrome in pediatric patients, 1997-2000, in Germany and Austria: a prospective study.
- Author
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Gerber A, Karch H, Allerberger F, Verweyen HM, and Zimmerhackl LB
- Subjects
- Austria epidemiology, Child, Child, Preschool, Culture Media, Escherichia coli classification, Escherichia coli isolation & purification, Escherichia coli Infections microbiology, Escherichia coli O157 classification, Escherichia coli O157 metabolism, Feces microbiology, Female, Germany epidemiology, Hemolytic-Uremic Syndrome microbiology, Humans, Incidence, Infant, Male, Prospective Studies, Sentinel Surveillance, Serotyping, Escherichia coli metabolism, Escherichia coli Infections epidemiology, Escherichia coli Infections physiopathology, Hemolytic-Uremic Syndrome epidemiology, Hemolytic-Uremic Syndrome physiopathology, Shiga Toxins biosynthesis
- Abstract
Hemolytic-uremic syndrome (HUS) is mainly associated with foodborne infections by Shiga toxin-producing Escherichia coli (STEC). From January 1997 through December 2000, 394 children with HUS were evaluated in a prospective multicenter surveillance study in Germany and Austria (incidences, 0.7/100,000 and 0.4/100,000 children <15 years old, respectively). Blood leukocytosis was associated with increased detection of STEC in stool cultures (P<.01) and a more severe disease course. Risk of death was associated with cerebral involvement (P<.01). Most strikingly, non-O157:H7 STEC were detected in 43% of stool cultures of patients with HUS: O26 was detected in 15%, sorbitol-fermenting O157:H(-) in 10%, O145 in 9%, O103 in 3%, and O111 in 43%. Patients with O157:H7 serotypes required dialysis for a longer time and had bloody diarrhea detected more frequently, compared with patients with non-O157:H7 serotypes (P<.05). This large study in children with HUS underlines the rising importance of non-O157:H7 serotypes, and, despite increased public awareness, the number of patients remained unchanged.
- Published
- 2002
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