The United States National Prospective Hemolytic Uremic Syndrome Study: Microbiologic, Serologic, Clinical, and Epidemiologic Findings

• Published in: The Journal of infectious diseases Vol. 183; no. 7; pp. 1063 - 1070
• Main Authors: Banatvala, Nicholas, Griffin, Patricia M., Greene, Katherine D., Barrett, Timothy J., Bibb, William F., Green, James H., Wells, Joy G.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-04-2001; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Antibodies; Antibodies, Bacterial - analysis; Bacteriology; Biological and medical sciences; Child; Child, Preschool; Diarrhea; Diarrhea - complications; Diseases; Epidemiology; Escherichia coli; Escherichia coli O157; Escherichia coli O157 - genetics; Escherichia coli O157 - immunology; Escherichia coli O157 - isolation & purification; Feces - microbiology; Female; Fundamental and applied biological sciences. Psychology; Hemolytic uremic syndrome; Hemolytic-Uremic Syndrome - epidemiology; Hemolytic-Uremic Syndrome - immunology; Hemolytic-Uremic Syndrome - microbiology; Humans; Immunoglobulin G - blood; Immunoglobulin M - blood; Incidence; Infant; Infections; Lipopolysaccharides - immunology; Major Articles; Male; Microbiology; Middle Aged; Population Surveillance; Postpartum Period; Pregnancy; Pregnancy Complications, Infectious - microbiology; Prospective Studies; Purpura, Thrombotic Thrombocytopenic - microbiology; Serology; Serotyping; Shiga toxins; Specimens; United States - epidemiology; Virology; United States; North America; America; USA; Skin disease; Growth; Escherichia coli; IgG; Cardiovascular disease; Hemopathy; IgM; Vascular disease; Hemolytic anemia; Lipopolysaccharide; Bacteria; Feces; Serotype; Child; Enterobacteriaceae; Kidney disease; Human; Thrombocytopenia; Nervous system diseases; Urinary system disease; Hemolytic uremic syndrome; Antibody; Acute; Use; Vascular disorders of the skin; Toxin; Platelet; Renal failure; Capillary vessel disease; Isolate; Coagulopathy
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/319269

The frequency of Shiga toxin–producing Escherichia coli (STEC) serotypes associated with postdiarrheal hemolytic uremic syndrome (HUS) cases among children and adults in the United States and the proportion with IgM or IgG lipopolysaccharide antibodies to E. coli O157 were determined by use of a nationwide sample from January 1987 through December 1991. Among 83 patients, STEC were isolated from 30 (43%) of 70 whose stool cultures yielded bacterial growth (25 E. coli O157 isolates and 5 non-O157 STEC isolates). Fifty-three (80%) of 66 patients with serum samples had positive O157 lipopolysaccharide antibody titers. Of the 83 patients, 60 (72%) had evidence of STEC infection, including 6 of 8 adults whose illnesses also met criteria for thrombotic thrombocytopenic purpura. Data from a subset of patients suggest that E. coli O157 was the cause of ⩾80% of the STEC infections. All 3 women who were postpartum had evidence of E. coli O157 infection. STEC infection should be considered the likely cause for all persons with postdiarrheal HUS