A Nationwide Case-Control Study of Escherichia coli O157:H7 Infection in the United States

• Published in: The Journal of infectious diseases Vol. 177; no. 4; pp. 962 - 966
• Main Authors: Slutsker, Laurence, Ries, Allen A., Maloney, Kathleen, Wells, Joy G., Greene, Katherine D., Griffin, Patricia M.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-04-1998; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Aged; Antimicrobials; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Case-Control Studies; Child; Child, Preschool; Diarrhea; Diarrhea - microbiology; Disease Transmission, Infectious; Diseases; Escherichia coli; Escherichia coli Infections - diagnosis; Escherichia coli Infections - epidemiology; Escherichia coli Infections - transmission; Escherichia coli O157; Feces - microbiology; Female; Food Handling; Ground beef; Hamburgers; Hemolytic uremic syndrome; Human bacterial diseases; Humans; Infant; Infant, Newborn; Infections; Infectious diseases; Major Articles; Male; Meat - microbiology; Medical sciences; Middle Aged; Multivariate Analysis; Predisposing factors; Preventive medicine; Restaurants; Risk Factors; Swimming; United States - epidemiology; Water Microbiology; Water Supply; United States; North America; America; Kidney disease; Epidemic; Human; Urinary system disease; Hemolytic uremic syndrome; Colibacillosis; Escherichia coli; Hemopathy; Case control study; Infection; Hemolytic anemia; Etiology; Food poisoning; Renal failure; Bacteriosis; Bacteria; Enterobacteriaceae
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/515258

Risk factors for Escherichia coli O157:H7 infection were investigated in a case-control study at 10 medical centers throughout the United States. Among 73 case-patients and 142 matched controls, exposures in the 7 days before illness associated with E. coli O157:H7 infection in univariate analysis included consumption of hamburger (matched odds ratio [MOR], 3.8; 95% confidence interval [CI], 1.9–7.9), undercooked hamburger (MOR, 4.5; 95% CI, 1.6–12.2), or hot dogs (MOR, 2.2; 95% CI, 1.1–4.4); eating at a fast-food restaurant (MOR, 2.3; 95% CI, 1.1–4.6); drinking unchlorinated well water (MOR, 2.4; 95% CI, 1.1–5.7); swimming in a pond (MOR, 5.4; 95% CI, 1.1–26.0); and having a household member with diarrhea (MOR, 11.9; 95% CI, 2.7–53.5). In multivariate analysis, only eating undercooked hamburger remained associated with infection. Seven (8%) of 93 patients developed hemolytic uremic syndrome and 1 died. Prevention strategies aimed at modifying risk factors may help to reduce the risk of infection with E. coli O157:H7.