title: Virulence factors for hemolytic uremic syndrome, Denmark.
abstract: 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.
authors.affiliation: Danish National Institute of Infectious Diseases, Statens Serum Institut, Copenhagen, Denmark. set@ssi.dk
authors.forename: Steen
authors.initials: S
authors.lastname: Ethelberg
authors.forename: Katharina E P
authors.initials: KE
authors.lastname: Olsen
authors.forename: Flemming
authors.initials: F
authors.lastname: Scheutz
authors.forename: Charlotte
authors.initials: C
authors.lastname: Jensen
authors.forename: Peter
authors.initials: P
authors.lastname: Schiellerup
authors.forename: Jørgen
authors.initials: J
authors.lastname: Enberg
authors.forename: Andreas Munk
authors.initials: AM
authors.lastname: Petersen
authors.forename: Bente
authors.initials: B
authors.lastname: Olesen
authors.forename: Peter
authors.initials: P
authors.lastname: Gerner-Smidt
authors.forename: Kåre
authors.initials: K
authors.lastname: Mølbak
mesh_terms: 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
chemical_list: D018829:Adhesins, Bacterial; D002352:Carrier Proteins; D029968:Escherichia coli Proteins; D022641:Shiga Toxin 2; D037521:Virulence Factors; C073819:eaeA protein, E coli