title: Risk of haemolytic uraemic syndrome caused by shiga-toxin-producing Escherichia coli infection in adult women in Japan.
abstract: Shiga-toxin-producing Escherichia coli (STEC) infections usually cause haemolytic uraemic syndrome (HUS) equally in male and female children. This study investigated the localization of globotriaosylceramide (Gb3) in human brain and kidney tissues removed from forensic autopsy cases in Japan. A fatal case was used as a positive control in an outbreak of diarrhoeal disease caused by STEC O157:H7 in a kindergarten in Urawa in 1990. Positive immunodetection of Gb3 was significantly more frequent in female than in male distal and collecting renal tubules. To correlate this finding with a clinical outcome, a retrospective analysis of the predictors of renal failure in the 162 patients of two outbreaks in Japan was performed: one in Tochigi in 2002 and the other in Kagawa Prefecture in 2005. This study concludes renal failure, including HUS, was significantly associated with female sex, and the odds ratio was 4·06 compared to male patients in the two outbreaks. From 2006 to 2009 in Japan, the risk factor of HUS associated with STEC infection was analysed. The number of males and females and the proportion of females who developed HUS were calculated by age and year from 2006 to 2009. In 2006, 2007 and 2009 in adults aged >20 years, adult women were significantly more at risk of developing HUS in Japan.
authors.affiliation: Division of Bacteriology,Department of Microbiology and Immunology,Faculty of Medicine,Tottori University,Yonago,Japan.
authors.forename: J
authors.initials: J
authors.lastname: Fujii
authors.affiliation: Department of Epidemiology and International Health,Research Institute, International Medical Center of Japan,Toyama,Shinjuku-ku,Tokyo,Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mizoue
authors.affiliation: Department of Forensic Medicine,School of Medicine,University of Occupational and Environmental Health,Kitakyushu,Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kita
authors.affiliation: Saitama Children's Medical Center,Magome,Iwatsuki,Saitama,Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kishimoto
authors.affiliation: Saitama Children's Medical Center,Magome,Iwatsuki,Saitama,Japan.
authors.forename: K
authors.initials: K
authors.lastname: Joh
authors.affiliation: Utsunomiya City Institute of Public Health and Environment,Takebayashimachi,Utsunomiya,Tochigi,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakada
authors.affiliation: Utsunomiya City Institute of Public Health and Environment,Takebayashimachi,Utsunomiya,Tochigi,Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ugajin
authors.affiliation: Utsunomiya City Public Health Office,Takebayashimachi,Utsunomiya,Tochigi,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Naya
authors.affiliation: Utsunomiya City Public Health Office,Takebayashimachi,Utsunomiya,Tochigi,Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Infectious Disease Surveillance Center (IDSC),National Institute of Infectious Diseases (NIID),Toyama,Shinjuku-ku,Tokyo,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tada
authors.affiliation: Infectious Disease Surveillance Center (IDSC),National Institute of Infectious Diseases (NIID),Toyama,Shinjuku-ku,Tokyo,Japan.
authors.forename: N
authors.initials: N
authors.lastname: Okabe
authors.affiliation: Kagawa Prefectural Chusan Regional Health and Welfare Office,Dokichohigashi,Marugame,Kagawa,Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Maruyama
authors.affiliation: Kagawa Prefectural Shozu Regional Health and Welfare Office,Fuchisakikou,Tonoshocho,Shozugun,Kagawa,Japan.
authors.forename: K
authors.initials: K
authors.lastname: Saitoh
authors.affiliation: Division of Health Administration and Promotion,Department of Social Medicine,Faculty of Medicine,Tottori University,YonagoJapan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kurozawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D054323:Shiga-Toxigenic Escherichia coli / Q000502:physiology*; D014281:Trihexosylceramides / Q000032:analysis; D055815:Young Adult
chemical_list: D014281:Trihexosylceramides; C018549:globotriaosylceramide
keywords: Gb3; HUS; STEC; haemolytic uraemic syndrome