Enterohemorrhagic Escherichia coli (EHEC) in pediatric hemolytic-uremic syndrome: a prospective study in Germany and Austria.
Studies from Europe indicate that infections with enterohemorrhagic Escherichia coli (EHEC) non-O157:H7 strains are increasing in frequency as a cause of hemolytic-uremic syndrome (HUS). In 1997 a prospective study was performed in Germany and Austria to assess the distribution of EHEC serotypes, to characterize the clinical course and to examine environmental aspects. 95 children with a diagnosis of HUS were evaluated in Germany and Austria. Diarrhea, which was bloody in 67%, was reported in 97% of patients. Oligo-/anuria occurred in 76% of patients, of which 63% required dialysis. Two patients showed neurological sequelae at the 2-month follow-up, both of them were infected with non-O157:H7 serotypes. Case fatality in the acute stage was 3/95, in two of these patients EHEC was isolated. Stool and serum specimens were analyzed for the presence of EHEC and antibodies against O157 lipopolysaccharide (LPS). Serotype O157:H7 was identified in 36/58 (62%) isolates, 22 strains (38%) belonged to non-O157:H7. Combining stool culture with serology, EHEC infection was documented in 88% of patients, including three patients without diarrhea. Non-O157:H7 serotypes occurred in 77% of children up to 36 months of age and were the most prevalent serotype in children up to 12 months of age.
Verweyen
H M
HM
Childrens' University Hospital, Freiburg, Germany. hackl@kkl200.ukl.uni-freiburg.de
Karch
H
H
Allerberger
F
F
Zimmerhackl
L B
LB
D000907:Antibodies, Bacterial / Q000097:blood; D000918:Antibody Specificity; D001317:Austria; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000145:classification* / Q000276:immunology / Q000302:isolation & purification; D019453:Escherichia coli O157 / Q000145:classification / Q000276:immunology / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005260:Female; D005858:Germany; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012703:Serotyping; D013997:Time Factors
D000907:Antibodies, Bacterial