Escherichia coli O157:H7 and the hemolytic uremic syndrome: importance of early cultures in establishing the etiology.
Fifty-two patients were studied prospectively to determine the etiology of postdiarrheal hemolytic uremic syndrome (HUS). Escherichia coli O157:H7 was isolated from 33 patients (63.4%). If stool obtained within 2 days of the onset of diarrhea was cultured for E. coli O157:H7, the recovery rate was 100%. This rate decreased to 91.7% and 33.3% if stool was cultured for this pathogen 3-6 or greater than or equal to 7 days, respectively, after diarrhea began. The culture-positive group was more likely to have had bloody diarrhea and fecal leukocytes and to have received transfusions than the culture-negative group but was otherwise similar in clinical characteristics. E. coli O157:H7 is the predominant pathogen associated with HUS in western Washington. Recovery of this pathogen is highly dependent on obtaining stool cultures within 6 days of onset of diarrhea.
Tarr
P I
PI
Department of Pediatrics, University of Washington, Seattle 98195.
Neill
M A
MA
Clausen
C R
CR
Watkins
S L
SL
Christie
D L
DL
Hickman
R O
RO
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003092:Colitis / Q000150:complications / Q000188:drug therapy; D003967:Diarrhea / Q000150:complications* / Q000382:microbiology; D004926:Escherichia coli / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000150:complications* / Q000382:microbiology; D005243:Feces / Q000382:microbiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000188:drug therapy; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000900:Anti-Bacterial Agents