Virulence factors for hemolytic uremic syndrome, Denmark.
We present an analysis of strain and patient factors associated with the development of bloody diarrhea and hemolytic uremic syndrome (HUS) among Shiga toxin-producing Escherichia coli (STEC) patients registered in Denmark in a 6-year period. Of 343 STEC patients, bloody diarrhea developed in 36.4% and HUS in 6.1%. In a multivariate logistic regression model, risk factors for bloody diarrhea were the eae and stx2 genes, O groups O157 and O103, and increasing age. Risk factors for HUS were presence of the stx2 (odds ratio [OR] 18.9) and eae (OR undefined) genes, being a child, and having bloody diarrhea. O group O157, although associated with HUS in a univariate analysis (OR 4.0), was not associated in the multivariate analysis (OR 1.1). This finding indicates that, rather than the O group, the combined presence of the eae and stx2 genes is an important predictor of HUS.
Ethelberg
Steen
S
Danish National Institute of Infectious Diseases, Statens Serum Institut, Copenhagen, Denmark. set@ssi.dk
Olsen
Katharina E P
KE
Scheutz
Flemming
F
Jensen
Charlotte
C
Schiellerup
Peter
P
Enberg
Jørgen
J
Petersen
Andreas Munk
AM
Olesen
Bente
B
Gerner-Smidt
Peter
P
Mølbak
Kåre
K
D018829:Adhesins, Bacterial / Q000235:genetics; D000367:Age Factors; D002352:Carrier Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D003718:Denmark; D003967:Diarrhea / Q000503:physiopathology / Q000821:virology; D004926:Escherichia coli / Q000235:genetics / Q000378:metabolism / Q000472:pathogenicity*; D004927:Escherichia coli Infections / Q000503:physiopathology / Q000821:virology; D029968:Escherichia coli Proteins / Q000235:genetics; D006463:Hemolytic-Uremic Syndrome / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D007223:Infant; D012307:Risk Factors; D022641:Shiga Toxin 2 / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics
D018829:Adhesins, Bacterial; D002352:Carrier Proteins; D029968:Escherichia coli Proteins; D022641:Shiga Toxin 2; D037521:Virulence Factors; C073819:eaeA protein, E coli