title: [Hemolytic uremic syndrome caused by Shiga-toxin-producing Escherichia coli].
abstract: Every year in France, approximately one hundred children, aged from 6 months to 3 years, develop hemolytic uremic syndrome (HUS) secondary to Shiga toxin-producing Escherichia coli (STEC) infection, mostly the O157:H7 serotype. Except during outbreaks, STEC-HUS is less frequent in adults. The main route of transmission is the consumption of undercooked ground beef or unpasteurized dairy products, or household contacts with STEC diarrhea. Mortality is 1 to 2%. Half of patients require dialysis at the acute phase, the majority will recover normal renal function but approximately 30% will suffer renal sequelae. The risk of sequelae is important if the duration of anuria has been more than 5 days. Treatment of STEC-HUS is mostly supportive. The efficacy of plasma exchanges is not demonstrated and that of eculizumab, a complement blocker, especially in case of central nervous system or cardiac involvement, uncertain. Prevention of STEC-HUS relies on simple methods, often unknown of parents of young children, with the French general population being scarcely informed. However, the surveillance of STEC-infections/HUS by the Institut de veille sanitaire and the Reference Center for E. coli infections allows the early detection of outbreaks and their source of contamination. This prevents the emergence of new cases by withdrawing the suspected food from the market and diffusing the information to the population (return of suspected food).
authors: Service de néphrologie, AP-HP, hôpital Robert-Debré, 75019 Paris, France. chantal.loirat@rdb.aphp.fr
authors: Chantal
authors: C
authors: Loirat
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003967:Diarrhea / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D006463:Hemolytic-Uremic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D007223:Infant; D054323:Shiga-Toxigenic Escherichia coli / Q000472:pathogenicity / Q000502:physiology*