title: Enterohaemorrhagic Escherichia coli in human medicine.
abstract: Enterohaemorrhagic Escherichia coli (EHEC) are the pathogenic subgroup of Shiga toxin (Stx)-producing E. coli. EHEC can cause non-bloody and bloody diarrhoea, and the haemolytic uraemic syndrome (HUS). HUS is a major cause of acute renal failure in children. E. coli O57:H7 is the predominant, but far from being the only, serotype that can cause HUS. The cascade leading from gastrointestinal infection to renal impairment is complex, with the microvascular endothelium being the major histopathological target. EHEC also produce non-Stx molecules, such as cytolethal distending toxin, which can contribute to the endothelial or vascular injury. Because there are no specific therapies for EHEC infections, efficient reservoir and human preventive strategies are important areas of ongoing investigations. This review will focus on the microbiology, epidemiology, and pathophysiology of EHEC-associated diseases, and illustrate future challenges and opportunities for their control.
authors.affiliation: Institute for Hygiene, and National Consulting Laboratory on Haemolytic Uraemic Syndrome, University Hospital Münster, Robert Koch Str. 41, D-48149 Münster, Germany. hkarch@uni-muenster.de
authors.forename: Helge
authors.initials: H
authors.lastname: Karch
authors.forename: Phillip I
authors.initials: PI
authors.lastname: Tarr
authors.forename: Martina
authors.initials: M
authors.lastname: Bielaszewska
mesh_terms: D004927:Escherichia coli Infections / Q000378:metabolism* / Q000473:pathology; D019453:Escherichia coli O157 / Q000378:metabolism / Q000472:pathogenicity*; D006463:Hemolytic-Uremic Syndrome / Q000382:microbiology* / Q000503:physiopathology*; D006801:Humans; D009336:Necrosis; D022603:Shiga Toxins / Q000378:metabolism*
chemical_list: D022603:Shiga Toxins