title: Haemolytic uraemic syndrome and Shiga toxin-producing Escherichia coli infection in children in France. The Société de Néphrologie Pédiatrique.
abstract: We conducted a study to determine the incidence of haemolytic uraemic syndrome (HUS) in children in France and to assess the role of Shiga-toxin-producing Escherichia coli (STEC) infection in the aetiology of HUS. In collaboration with the Société de Néphrologie Pédiatrique we undertook a retrospective review of all cases of HUS hospitalized from January 1993 to March 1995 and a 1-year prospective study (April 1995-March 1996) of epidemiological and microbiological features of cases of HUS. The polymerase chain reaction (PCR) procedure was used to detect stx, eae, e-hlyA genes directly from case stool samples. Serum samples from cases were examined for antibodies to lipopolysaccharide (LPS) of 26 major STEC serogroups. Two hundred and eighty-six cases were reported. The average incidence per year was 0.7/10(5) children < 15 years and 1.8/10(5) children < 5 years. During the prospective study, 122/130 cases were examined for evidence of STEC infection using PCR and/or serological assays and 105 (86%) had evidence of STEC infection. Serum antibodies to E. coli O157 LPS were detected in 79 (67%) cases tested. In conclusion, this study showed that STEC infection is an important cause of HUS in children in France, with a high proportion related to the O157 serogroup.
authors.affiliation: Réseau National de Santé Publique, Saint-Maurice, France.
authors.forename: B
authors.initials: B
authors.lastname: Decludt
authors.forename: P
authors.initials: P
authors.lastname: Bouvet
authors.forename: P
authors.initials: P
authors.lastname: Mariani-Kurkdjian
authors.forename: F
authors.initials: F
authors.lastname: Grimont
authors.forename: P A
authors.initials: PA
authors.lastname: Grimont
authors.forename: B
authors.initials: B
authors.lastname: Hubert
authors.forename: C
authors.initials: C
authors.lastname: Loirat
mesh_terms: D018829:Adhesins, Bacterial; D000293:Adolescent; D017677:Age Distribution; D000907:Antibodies, Bacterial / Q000097:blood; D001425:Bacterial Outer Membrane Proteins / Q000096:biosynthesis / Q000235:genetics; D001427:Bacterial Toxins / Q000096:biosynthesis* / Q000235:genetics; D002352:Carrier Proteins; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D015897:Comorbidity; D003967:Diarrhea / Q000175:diagnosis / Q000382:microbiology; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology*; D019453:Escherichia coli O157 / Q000235:genetics / Q000302:isolation & purification / Q000378:metabolism*; D029968:Escherichia coli Proteins; D005243:Feces / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012698:Serologic Tests; D017678:Sex Distribution; D022603:Shiga Toxins
chemical_list: D018829:Adhesins, Bacterial; D000907:Antibodies, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001427:Bacterial Toxins; D002352:Carrier Proteins; D029968:Escherichia coli Proteins; D022603:Shiga Toxins; C073819:eaeA protein, E coli