title: Evidence of infection with organisms producing Shiga-like toxins in household contacts of children with the hemolytic uremic syndrome.
abstract: We conducted a prospective study in 87 household contacts of 51 children with hemolytic uremic syndrome to determine the frequency of infection with Shiga-like toxin-producing bacteria. Gastrointestinal tract symptoms occurred in only 1 of 87 contacts. Free fecal toxin was detected in 25 of 64 (39%) of the household members. Neutralization with specific antisera to Shiga-like toxins I and II (SLT-I, SLT-II) revealed that in 6 of these household contacts only SLT-I was present in stool, in 10 only SLT-II was present and in 9 both toxins were found. Thirty-three percent of the hemolytic uremic syndrome families in which 2 or more members were studied had more than 1 household member with free fecal toxin in stool. None of the household contacts was found to have E. coli O157:H7 in feces. Serum samples were available in 77 household contacts; 75% (58 of 77) had serum neutralizing titers of greater than or equal to 1:4 to 1 or both toxins. In those contacts for whom paired sera were available, seroconversion was found in 10 of 24 (42%). These data show that household contacts of children with hemolytic uremic syndrome are commonly colonized with Shiga-like toxin-producing E. coli and seroconversion to Shiga-like toxins occurs frequently in family members of children with hemolytic uremic syndrome.
authors.affiliation: Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina.
authors.forename: E L
authors.initials: EL
authors.lastname: Lopez
authors.forename: M
authors.initials: M
authors.lastname: Diaz
authors.forename: S
authors.initials: S
authors.lastname: Devoto
authors.forename: S
authors.initials: S
authors.lastname: Grinstein
authors.forename: M
authors.initials: M
authors.lastname: Woloj
authors.forename: B E
authors.initials: BE
authors.lastname: Murray
authors.forename: E
authors.initials: E
authors.lastname: Rubeglio
authors.forename: F
authors.initials: F
authors.lastname: Mendilaharzu
authors.forename: M
authors.initials: M
authors.lastname: Turco
authors.forename: M
authors.initials: M
authors.lastname: Vasquez
mesh_terms: D000328:Adult; D001118:Argentina / Q000453:epidemiology; D001427:Bacterial Toxins / Q000096:biosynthesis*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D004926:Escherichia coli / Q000378:metabolism*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D022622:Shiga Toxin 1; D022641:Shiga Toxin 2
chemical_list: D001427:Bacterial Toxins; D022622:Shiga Toxin 1; D022641:Shiga Toxin 2