High incidence of serum antibodies to Escherichia coli O157 lipopolysaccharide in children with hemolytic-uremic syndrome

Bitzan, Martin; Moebius, Eckehard; Ludwig, Kerstin U.; Müller‐Wiefel, D. E.; Heesemann, Jürgen; Karch, Helge

doi:10.1016/s0022-3476(05)82049-9

Cited by 133 publications

(87 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies reported that IgG and IgM antibodies to E coli O157 are good indicators of recent infection. 15,34,35 In 1992, 36 investigated an outbreak of HUS in Italy. They isolated E coli O111 from the stool of a case-patient and subsequently proved that 6 of 7 HUS case-patients had antibodies to O111 LPS using an ELISA-based test.…”

Section: Discussionmentioning

confidence: 99%

Hemolytic-Uremic Syndrome and Escherichia coliO121 at a Lake in Connecticut, 1999

McCarthy

Barrett²,

Hadler³

et al. 2001

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Objective. Non-O157 Shiga toxin-producing Escherichia coli (STEC) have emerged as an important public health problem. Outbreaks attributed to non-O157 STEC rarely are reported. In 1999, follow-up of routine surveillance reports of children with hemolyticuremic syndrome (HUS) identified a small cluster of 3 cases of HUS, all of whom had spent overlapping time in a Connecticut lake community in the week before onset of symptoms. We conducted an investigation to determine the magnitude and source of the outbreak and to determine risk factors associated with the transmission of illness.Methods. We conducted a cohort study and an environmental investigation. The study population included all people who were at the lake in a defined geographic area during July 16 -25, 1999. This time and area were chosen on the basis of interviews with the 3 HUS casepatients. A case was defined as diarrhea (>3 loose stools/d for >3 days) in a person who was at the lake during July 16 -25, 1999. Stool samples were requested from any lake resident with diarrheal illness. Stools were cultured for Salmonella, Shigella, Campylobacter, and E coli O157. Broth cultures of stools were tested for Shiga toxin. Case-patients were asked to submit a serum specimen for antibody testing to lipopolysaccharides of selected STEC. Environmental samples from sediment, drinking water, lake water, and ice were obtained and cultured for E coli and tested for Shiga toxin. An environmental evaluation of the lake was conducted to identify any septic, water supply system, or other environmental condition that could be related to the outbreak.Results. Information was obtained for 436 people from 165 (78%) households. Eleven (2.5%) people had illnesses that met the case definition, including the 3 children with HUS. The attack rate was highest among those who were younger than 10 years and who swam in the lake on July 17 or 18 (12%; relative risk [RR]: 7.3). Illness was associated with swimming (RR ‫؍‬ 8.3) and with swallowing water while swimming (RR ‫؍‬ 7.0) on these days. No person who swam only after July 18 developed illness. Clinical characteristics of case-patients included fever (27%), bloody diarrhea (27%), and severe abdominal cramping (73%). Only the 3 children with HUS required hospitalization. No bacterial pathogen was isolated from the stool of any case-patient. Among lake residents outside the study area, E coli O121:H19 was obtained from a Shiga toxin-producing isolate from a toddler who swam in the lake. Serum was obtained from 7 of 11 case-patients. Six of 7 case-patients had E coli O121 antibody titers that ranged from 1:320 to >1:20 480. E coli indicative of fecal contamination was identified from sediment and water samples taken from a storm drain that emptied into the beach area and from a stream bed located between 2 houses, but no Shiga toxin-producing strain was identified.Conclusions. Our findings are consistent with a transient local beach contamination in mid-July, probably with E coli O121:H19, which seems to be able to cause...

show abstract

Section: Discussionmentioning

confidence: 99%

Hemolytic-Uremic Syndrome and Escherichia coliO121 at a Lake in Connecticut, 1999

McCarthy

Barrett²,

Hadler³

et al. 2001

Pediatrics

View full text Add to dashboard Cite

show abstract

“…In contrast, others have reported detecting antibodies to another type of E. coli O antigen which was distinct from the E. coli O antigen isolated from the patients' stools (4,10,21). These studies reported that the antibodies may cross-react with pathogens of other serotypes (4) or that the serological test used might have been unsuitable for specifically detecting EHEC without O157 (10) and that the patients might have been concurrently infected with E. coli O157 and non-O157 strains (21).…”

Section: Figmentioning

confidence: 99%

“…These studies reported that the antibodies may cross-react with pathogens of other serotypes (4) or that the serological test used might have been unsuitable for specifically detecting EHEC without O157 (10) and that the patients might have been concurrently infected with E. coli O157 and non-O157 strains (21). However, these studies investigated only a single patient in sporadic cases; they failed to evaluate the results for reaction of antibodies to the O antigen of E. coli.…”

Section: Figmentioning

confidence: 99%

“…Conversely, HUS has less frequently been reported in outbreaks caused by non-O157 EHEC (i.e., EHEC O104) (6)(7)(8). On the other hand, HUS patients without EHEC isolates have frequently been described (3,4,9,10). Detecting EHEC in the stools of patients administered antibiotics long after the onset of diarrhea can be challenging because the organisms are typically isolated only from the diarrhea stool tested soon after onset (9,(11)(12)(13)(14).…”

mentioning

confidence: 99%

“…The presence of antibodies to the LPSs of E. coli O antigen in the sera of patients with HUS was first reported by Chart et al (3) in 1991. Thereafter, antibodies to the LPSs of E. coli O antigen have been measured using methods such as enzyme-linked immunosorbent assay (ELISA) (2,3,9,10), indirect hemagglutination assay (IHA) (4), and passive hemagglutination assay (PHA) (19). In Japan, a direct agglutination test has been used to detect antibodies to E. coli O antigens (20,21) after mixing a patient's serum with heat-inactivated whole bacterial cells that were used as the antigen.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Serodiagnosis Using Microagglutination Assay during the Food-Poisoning Outbreak in Japan Caused by Consumption of Raw Beef Contaminated with Enterohemorrhagic Escherichia coli O111 and O157

et al. 2014

View full text Add to dashboard Cite

A microagglutination (MA) assay to identify antibodies to Escherichia coli O111 and O157 was conducted in sera collected from 60 patients during a food-poisoning outbreak affecting 181 patients in Japan which was caused by the consumption of contaminated raw beef. Enterohemorrhagic E. coli (EHEC) O111:H8 and/or O157:H7 was isolated from the stools of some of the patients, but the total rate of positivity for antibodies to O111 (45/60, 75.0%) was significantly higher than that for antibodies to O157 (10/60, 16.7%). The MA titers of antibodies to O111 measured in patients with hemolytic-uremic syndrome and bloody diarrhea were higher than those measured in patients with only diarrhea. In patients from whose stool no isolates of E. coli O111 and O157 were obtained, the positive antibody detection rates were 12/19 (63.2%) for O111 and 2/19 (10.5%) for O157, and the MA titers of antibodies to O111 measured were higher than those to O157. Similarly, the MA titers of antibodies to O111 were significantly higher than those to O157, regardless of the other groups, including groups O111, O111 and O157, and O157. These serodiagnosis results suggest that EHEC O111:H8 stx 2 played a primary role in the pathogenesis of this outbreak. Furthermore, our findings suggest that the isolates from the patients' stool specimens were not always the major causative pathogen in patients with multiple EHEC infections, because the sera from patients from whose stools only O157 was isolated were positive for antibodies to O111. Measuring antibodies to E. coli O antigen is helpful especially in cases with multiple EHEC infections, even with a non-O157 serotype.

show abstract

Postdiarrheal Shiga Toxin–Mediated Hemolytic Uremic Syndrome

Siegler¹

2003

JAMA

View full text Add to dashboard Cite

High incidence of serum antibodies to Escherichia coli O157 lipopolysaccharide in children with hemolytic-uremic syndrome

Cited by 133 publications

References 34 publications

Hemolytic-Uremic Syndrome and Escherichia coliO121 at a Lake in Connecticut, 1999

Hemolytic-Uremic Syndrome and Escherichia coliO121 at a Lake in Connecticut, 1999

Serodiagnosis Using Microagglutination Assay during the Food-Poisoning Outbreak in Japan Caused by Consumption of Raw Beef Contaminated with Enterohemorrhagic Escherichia coli O111 and O157

Postdiarrheal Shiga Toxin–Mediated Hemolytic Uremic Syndrome

Contact Info

Product

Resources

About