Haemolytic uremic syndrome surveillance in children less than 15 years in Belgium, 2009–2015

Jacquinet, Stéphanie; Rauw, Klara De; Piérard, Denis; Godefroid, Nathalie; Collard, Laure; Hoeck, Koen Van; Sabbe, Martine

doi:10.1186/s13690-018-0289-x

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…The average annual incidence rate of HUS in Finland (0.57 cases per 100,000 children) equals the incidence rates in Germany, Austria, British Isles, France, and Norway [14,15,20,33]. Consistent with most of the previous studies [10,14,20,37], the majority (66%) of HUS cases in Finland were caused by STEC serogroup O157. The proportion of non-O157 serogroups (O26, O80, O103, O104, O145), however, has increased since the early 2010s [10,33].…”

Section: Discussionsupporting

confidence: 85%

“…Importantly, however, the outcome of the patients was optimistic with no deaths and neurological sequelae in only two patients. While neurological manifestations are the main cause of acute mortality in HUS (2–5%) [ 13 , 20 , 22 , 37 , 41 ], none of our patients died. Seven children with severe neurological symptoms were treated with PE, which was used as a treatment modality in many centers, especially in cases with neurological symptoms [ 11 ].…”

Section: Discussionmentioning

confidence: 83%

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Hemolytic uremic syndrome caused by Shiga toxin–producing Escherichia coli in children: incidence, risk factors, and clinical outcome

et al. 2020

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Background Hemolytic uremic syndrome (HUS) is a multisystemic disease. In a nationwide study, we characterized the incidence, clinical course, and prognosis of HUS caused by Shiga toxin (Stx)-producing Escherichia coli (STEC) strains with emphasis on risk factors, disease severity, and long-term outcome. Methods The data on pediatric HUS patients from 2000 to 2016 were collected from the medical records. STEC isolates from fecal cultures of HUS and non-HUS patients were collected from the same time period and characterized by whole genome sequencing analysis. Results Fifty-eight out of 262 culture-positive cases developed verified (n = 58, 22%) STEC-HUS. Another 29 cases had probable STEC-HUS, the annual incidence of STEC-HUS being 0.5 per 100,000 children. Eleven different serogroups were detected, O157 being the most common (n = 37, 66%). Age under 3 years (OR 2.4), stx2 (OR 9.7), and stx2a (OR 16.6) were found to be risk factors for HUS. Fifty-five patients (63%) needed dialysis. Twenty-nine patients (33%) developed major neurological symptoms. Complete renal recovery was observed in 57 patients after a median 4.0 years of follow-up. Age under 3 years, leukocyte count over 20 × 10 9 /L, and need for dialysis were predictive factors for poor renal outcome. Conclusions Age under 3 years, stx2, and stx2a were risk factors for HUS in STEC-positive children. However, serogroup or stx types did not predict the renal outcome or major CNS symptoms.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 83%

Hemolytic uremic syndrome caused by Shiga toxin–producing Escherichia coli in children: incidence, risk factors, and clinical outcome

et al. 2020

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“…The mean incidence of STEC-HUS in New Zealand in children under age 5 years appear is higher than many other developed countries, with it increasing from 2.2 to 2.85 per 100,000 over the two time periods. In a study from Belgium between 2009 and 2015, the annual incidence in children under 5 was 1.2 per 100,000 (range 0.6-2.1) [34,35]. A study from our nearest neighbour, Australia, (1994 to 1998) reported an incidence of 1.35 per 100,000/year, but a more recent study from the same country (2000 to 2010), showed the annual as the introduction of more sensitive identification methods that utilised molecular techniques.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2022

Int J Pediatr Res

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Background:The epidemiology of childhood haemolytic uraemic syndrome in New Zealand was on active surveillance from January 1, 1998 to December 31, 2020. The aim of this study is to describe the demographic, epidemiological and some clinical features of childhood Shiga toxin producing E. coli infections (STEC) and its association with diarrhoea associated haemolytic uremic syndrome (D+HUS) over past 23 years. Methods:The New Zealand Paediatric Surveillance Unit (NZPSU) sent out a monthly report card to all practising paediatricians with conditions under active surveillance. Those paediatricians who had cared for a child aged 0 to 15 years of age with D+HUS in the past month were requested to report their patient to the NZPSU. The reporting clinicians were then contacted by the principal investigator who sent out a questionnaire to the clinician requesting patient clinical and laboratory information. The group was divided into 2 cohorts; A: 1998-2008 and B: 2009-2020 to examine trends in STEC infections and childhood D+HUS.Results: Two hundred and twenty six children aged 3 months up to 15 years (median 2.8 years (IQR 1.7-4.9) were diagnosed with D+HUS. E. coli O157: H7 was identified in 130 (57.1%) and 8 were due to serotypes 026 H11 and 0113. Over the 23 years, the mean annual incidence in children under age 5 between cohort A and cohort B was not statistically significant (2.2 per 100,000 vs. 2.85 per 100,000. The mean annual incidence was 1.2 per 100,000 in all children under age 15 for the whole study period. Disease severity as measured by the requirement for acute dialysis had not changed and was required in 128/226 (56.2%) of children for a median of 9 days (range 1-38). The overall mortality was 3/226 (1.3%), which was due exclusively to severe cerebral injury. Conclusion:There has been an increase in STEC infections in childhood over the past 23 years, in part due improved methods of detection, however, the incidence children developing D+HUS has remained stable over the study period. E. coli serotypes other than O157:H7 have increased in prevalence over the past 6 years due to methodological changes in diagnostic laboratories, but with only a small number of infected children developing D+HUS. The mortality rate over the study period was low, consistent with other reported series.

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“…[5] Shiga toxin-producing E. coli HUS is the most common cause of acute kidney injury in children. [1,[6][7][8][9] Since 2004, STEC is a noti able disease in Ireland and we consistently have the highest reported rate of STEC infection in Europe (19.4 per 100,000 in 2017). [10] Neurological involvement is reported in approximately 30% of all types of HUS.…”

Section: Introductionmentioning

confidence: 98%

Neurological Involvement in Children with Hemolytic Uremic Syndrome

Costigan¹,

Raftery²,

Carroll³

et al. 2021

Preprint

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Our objective was to establish the rate of neurological involvement in STEC-HUS and describe the clinical presentation, management and outcome. A retrospective chart review of children aged ≤16 years with STEC-HUS in Children’s Health Ireland from 2005 to 2018 was conducted. Laboratory confirmation of STEC infection was required for inclusion. Neurological involvement was defined as encephalopathy, focal neurological deficit and/or seizure activity. Data on clinical presentation, management and outcome were collected. We identified 240 children with HUS; 202 had confirmed STEC infection. Neurological involvement occurred in 22 (10.9%). The most common presentation was seizures (72.7%). In the neurological group, 19 (86.4%) were treated with plasma exchange and/or Eculizumab. Of the 21 surviving children with neurological involvement, 19 (90.5%) achieved a complete neurological recovery. A higher proportion of children in the neurological group had renal sequelae (26.6% vs. 11.5 %, P=.031). One patient died from multi-organ failure. Conclusion: We have identified the rate of neurological involvement in a large cohort of children with STEC-HUS as 10.9%. Neurological involvement in STEC-HUS is associated with good long-term outcome (complete neurological recovery in 90.5%) and a low case-fatality rate (4.5%) in our cohort.

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Haemolytic uremic syndrome surveillance in children less than 15 years in Belgium, 2009–2015

Cited by 9 publications

References 24 publications

Hemolytic uremic syndrome caused by Shiga toxin–producing Escherichia coli in children: incidence, risk factors, and clinical outcome

Hemolytic uremic syndrome caused by Shiga toxin–producing Escherichia coli in children: incidence, risk factors, and clinical outcome

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Neurological Involvement in Children with Hemolytic Uremic Syndrome

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