Hemolytic uremic syndrome with mild renal involvement due to Shiga toxin-producing Escherichia coli (STEC) O145 strain

Pérez, Lucía; Apezteguía, Lucía; Piñeyrúa, Cecilia; Dabezies, Agustín; Bianco, María Noel; Schelotto, Felipé; Varela, Gustavo

doi:10.1016/s0325-7541(14)70056-2

Cited by 9 publications

(10 citation statements)

References 6 publications

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“…These findings reinforce our suggestion posed in previous communications about the local participation of non-O157 STEC strains in severe infant diseases and also addresses the importance of performing active surveillance of all forms of HUS [ 16 , 30 ]. The third STEC recovered strain which belonged to a serogroup not previously isolated in our country or in the region.…”

Section: Discussionsupporting

confidence: 91%

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Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

Varela

Batthyany

Bianco

et al. 2015

International Journal of Microbiology

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Infectious diarrhea, a common disease of children, deserves permanent monitoring in all social groups. To know the etiology and clinical manifestations of acute diarrhea in children up to 5 years of age from high socioeconomic level households, we conducted a descriptive, microbiological, and clinical study. Stools from 59 children with acute community-acquired diarrhea were examined, and their parents were interviewed concerning symptoms and signs. Rotavirus, adenovirus, and norovirus were detected by commercially available qualitative immunochromatographic lateral flow rapid tests. Salmonella, Campylobacter, Yersinia, and Shigella were investigated by standard bacteriological methods and diarrheagenic E. coli by PCR assays. We identified a potential enteric pathogen in 30 children. The most frequent causes of diarrhea were enteropathogenic E. coli (EPEC), viruses, Campylobacter, Salmonella, and Shiga-toxin-producing E. coli (STEC). Only 2 patients showed mixed infections. Our data suggest that children with viral or Campylobacter diarrhea were taken to the hospital earlier than those infected with EPEC. One child infected with STEC O26 developed “complete” HUS. The microbiological results highlight the importance of zoonotic bacteria such as atypical EPEC, Campylobacter, STEC, and Salmonella as pathogens associated with acute diarrhea in these children. The findings also reinforce our previous communications about the regional importance of non-O157 STEC strains in severe infant food-borne diseases.

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Section: Discussionsupporting

confidence: 91%

“…STEC strains recovered carried genes associated with severe diseases ( stx , eae , and ehx A); and one child infected with O26 STEC developed HUS. This is interesting because we have previously isolated STEC strains belonging to non-O157 serogroups from children with HUS from low-income households and also from bovine feces [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

Varela

Batthyany

Bianco

et al. 2015

International Journal of Microbiology

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“…Among the known eae subtypes described so far, four subtypes (β, ε, γ1, θ) have been reported to be associated with more virulent STEC and thus posing greater health risk 28 . In a previous study, the eae subtypes of STEC strains recovered from children with HUS in Uruguay, include γ1, γ2 and β1 29 , highlighting the clinical significance of these eae subtypes. In this study, we found that β1 and ζ3 were the most prevalent eae subtypes, which were detected in strains from different sources.…”

Section: Discussionmentioning

confidence: 89%

Genetic diversity of the intimin gene (eae) in non-O157 Shiga toxin-producing Escherichia coli strains in China

Yang

Sun

Fan

et al. 2020

Sci Rep

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Shiga toxin-producing Escherichia coli (STEC) is an important foodborne pathogen. The increasing incidence of non-O157 STEC has posed a great risk to public health. Besides the Shiga toxin (Stx), the adherence factor, intimin, coded by eae gene plays a critical role in STEC pathogenesis. In this study, we investigated the prevalence and polymorphisms of eae gene in non-O157 STEC strains isolated from different sources in China. Among 735 non-O157 STEC strains, eae was present in 70 (9.5%) strains. Eighteen different eae genotypes were identified in 62 eae-positive STEC strains with the nucleotide identities ranging from 86.01% to 99.97%. Among which, seven genotypes were newly identified in this study. The eighteen eae genotypes can be categorized into five eae subtypes, namely β1, γ1, ε1, ζ3 and θ. Associations between eae subtypes/genotypes and serotypes as well as origins of strains were observed in this study. Strains belonging to serotypes O26:H11, O103:H2, O111:H8 are associated with particular eae subtypes, i.e., β1, ε1, θ, respectively. Most strains from diarrheal patients (7/9, 77.8%) carried eae-β1 subtype, while most isolates from cattle (23/26, 88.5%) carried eae-ζ3 subtype. This study demonstrated a genetic diversity of eae gene in non-O157 STEC strains from different sources in China.

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“…Attention must also be given to its links with malnutrition and to the high cost of medical attention that impacts an already burdened health system in many developing countries [ 6 ]. Severe cases and related complications often require specialized care, which includes diarrheal diseases characterized by severe dehydration (found in cholera cases), bloody diarrhea caused by Shigella , haemolytic-uremic syndrome (HUS) associated with infection by Shiga toxin-producing E. coli (STEC), Guillain–Barré Syndrome (GBS) linked to Campylobacter, and invasive illness by Salmonella or acute abdominal pain due to mesenteric adenitis and Yersinia enterocolitica [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

DiarrheagenicEscherichia coliAssociated with Acute Gastroenteritis in Children from Soriano, Uruguay

Peirano

Bianco

Navarro

et al. 2018

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Introduction Acute diarrheal disease still deserves worldwide attention due to its high morbidity and mortality, especially in developing countries. While etiologic determination is not mandatory for management of all individual cases, it is needed for generating useful epidemiologic knowledge. Diarrheagenic Escherichia coli (DEC) are relevant enteropathogens, and their investigation requires specific procedures to which resources and training should be dedicated in reference laboratories. Methodology Following the hypothesis that enteric pathogens affecting children in towns located in the interior of Uruguay may be different from those found in Montevideo, we conducted a diagnostic survey on acute diarrheal disease in 83 children under 5 years of age from populations in the south of the country. Results DEC pathotypes were the only bacterial pathogens found in diarrheal feces (20.48%), followed by rotavirus (14.45%) and enteric adenovirus (4.81%). Atypical EPEC (aEPEC) was the most frequent DEC pathotype identified, and unexpectedly, it was associated with bloody diarrheal cases. These patients were of concern and provided with early consultation, as were children who presented with vomiting, which occurred most frequently in rotavirus infections. aEPEC serotypes were diverse and different from those previously reported in Montevideo children within the same age group and different from serotypes identified in regional and international studies. Enteroinvasive (EIEC) O96 : H19, associated with large outbreaks in Europe, was also isolated from two patients. Antibiotic susceptibility of pathogenic bacteria identified in this study was higher than that observed in previous national studies, which had been mainly carried out in children from Montevideo. Conclusion The reduced number of detected species, the marked prevalence of aEPEC, the scarce resistance traits, and the diverse range of serotypes in the virulent DEC identified in this study confirm that differences exist between enteropathogens affecting children from interior towns of Uruguay and those circulating among children in Montevideo.

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Hemolytic uremic syndrome with mild renal involvement due to Shiga toxin-producing Escherichia coli (STEC) O145 strain

Cited by 9 publications

References 6 publications

Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

Genetic diversity of the intimin gene (eae) in non-O157 Shiga toxin-producing Escherichia coli strains in China

DiarrheagenicEscherichia coliAssociated with Acute Gastroenteritis in Children from Soriano, Uruguay

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