The Association Between Idiopathic Hemolytic Uremic Syndrome and Infection by Verotoxin-Producing Escherichia coli

Forty pediatric patients with idiopathic hemolytic uremic syndrome (HUS) were investigated for evidence of infection by Verotoxin-producing Escherichia coli (VTEC). Fecal VTEC (belonging to at least six different O serogroups including O26, O111, O113, O121, O145, and O157) or specifically neutraliz...

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Bibliographic Details
Published in:The Journal of infectious diseases 1985-05, Vol.151 (5), p.775-782
Main Authors: Karmali, Mohamed A., Petric, Martin, Lim, Corazon, Fleming, Peter C., Arbus, Gerald S., Lior, Hermy
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Anemias. Hemoglobinopathies
Antibodies
Antibodies, Bacterial - analysis
Bacterial Toxins - analysis
Bacterial Toxins - biosynthesis
Biological and medical sciences
Child
Child, Preschool
Colitis
Convalescence
Cytotoxins
Diseases
Diseases of red blood cells
Escherichia coli
Escherichia coli - immunology
Escherichia coli - metabolism
Escherichia coli Infections - complications
Escherichia coli Infections - immunology
Escherichia coli Infections - microbiology
Female
Hematologic and hematopoietic diseases
Hemolytic uremic syndrome
Hemolytic-Uremic Syndrome - etiology
Hemolytic-Uremic Syndrome - microbiology
Humans
Infant
Infections
Male
Medical sciences
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Original Articles
Renal failure
Serotyping
Shiga Toxin 1
Shiga toxins
Vero cells
Viruses
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Summary:Forty pediatric patients with idiopathic hemolytic uremic syndrome (HUS) were investigated for evidence of infection by Verotoxin-producing Escherichia coli (VTEC). Fecal VTEC (belonging to at least six different O serogroups including O26, O111, O113, O121, O145, and O157) or specifically neutralizable free-fecal Verotoxin (VT) or both were detected in 24 (60%) patients but were not detected in 40 matched controls. Ten of 15 of the former developed fourfold or greater rises in VT-neutralizing antibody titers, as did six other patients who were negative for both fecal VTEC and VT. A total of 30 (75%) patients had evidence of VTEC infection by one or more criteria. We concluded that a significant association exists between idiopathic HUS and infection by VTEC. The detection of free-fecal VT was the most important procedure for the early diagnosis of this infection because, in our study, VTEC were never isolated in the absence of fecal VT, whereas fecal VT was often present even when VTEC were undetectable.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/151.5.775