Outbreak of haemolytic uraemic syndrome and bloody diarrhoea due to Escherichia coli O104:H4, south-west France, June 2011

Gault, G.; Weill, François‐Xavier; Mariani-Kurkdjian, P.; N, Jourdan-da Silva; L, King; Aldabe, B; Charron, Martine; N, Ong; Castor, C.; Macé, Muriel; Bingen, Édouard; Noël, Harold; Vaillant, Michel; Bone, Angie; Vendrely, Benoı̂t; Delmas, Yahsou; Combe, Christian; Bercion, Raymond; d'Andigne, E; Desjardin, M; Valk, Henriette de; Rolland, Patrick

doi:10.2807/ese.16.26.19905-en

Cited by 81 publications

(53 citation statements)

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“…For example, it is possible that differences in sprouting conditions between the German sprout farm and the French community center could have led to differences in diversity. These differences in conditions include use of well-water at a temperature of 20°C in the sprout farm in Germany (16), compared with tap water at ambient temperature (between 12 and 28°C) in the French outbreak (2). Seeds in France were also germinated for about 1.5 d longer.…”

Section: Discussionmentioning

confidence: 99%

“…food-borne outbreak | Shiga toxin | enteroaggregative E. coli | enterohemorrhagic E. coli I n May-July 2011, two outbreaks of bloody diarrhea and hemolytic uremic syndrome (HUS) occurred in Europe: one centered in Germany (around 4,000 cases of bloody diarrhea, 850 cases of HUS and 50 deaths), and a much smaller outbreak in southwest France, near Bordeaux (15 cases of bloody diarrhea, 9 of which progressed to HUS) (1)(2)(3)(4). Both outbreaks were caused by a strain of Shiga toxin-producing Escherichia coli of serotype O104:H4 (2, 5), which possesses a plasmid, pAA, characteristic of enteroaggregative E. coli, as well as a plasmid encoding an extended-spectrum β-lactamase (ESBL) (3).…”

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confidence: 99%

“…Based on conventional molecular epidemiological characterization (including virulence gene content, serotyping, multilocus sequence typing, rep-PCR, pulsed-field gel electrophoresis, optical mapping, and antimicrobial susceptibility testing), the outbreak strains in Germany and France appear identical (2,8) Data deposition: The sequences reported in this paper have been deposited in the GenBank database (accession nos. E. coli C227-11 AFRH01000000; E. coli C236-11 AFRI01000000; E. coli Ec04-8351 AFRL01000000; E. coli Ec11-3677 AFRM01000000; E. coli Ec09-7901 AFRK01000000; E. coli Ec11-4632-C1 AFVA01000000; E. coli Ec11-4632-C2 AFVB01000000; E. coli Ec11-4632-C3 AFVC01000000; E. coli Ec11-4632-C4 AFVD01000000; E. coli Ec11-4632-C5 AFVE01000000; E. coli Ec11-4404 AFUX01000000; E. coli Ec11-4522 AFUY01000000; E. coli Ec11-4623 AFUZ01000000; E. coli Ec11-5538 AFVF01000000; E. coli Ec11-5537 AFVG01000000; and E. coli Ec11-5536 AFVH01000000).…”

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confidence: 99%

“…Four hundred kilograms of the original seed shipment was sent to an English seed distributor, which then repacked seeds into 50-g packets passed on to French garden stores (7). The seeds from a packet were then germinated into sprouts at a children's community center, and the sprouts were served on June 8, 2011, leading to the French outbreak (2).…”

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confidence: 99%

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Genomic epidemiology of the Escherichia coli O104:H4 outbreaks in Europe, 2011

Grad

Lipsitch

Feldgarden

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

255

232

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International audienceThe degree to which molecular epidemiology reveals informationabout the sources and transmission patterns of an outbreakdepends on the resolution of the technology used and the samplesstudied. Isolates of Escherichia coli O104:H4 from the outbreak centeredin Germany in May–July 2011, and the much smaller outbreakin southwest France in June 2011, were indistinguishable by standardtests. We report a molecular epidemiological analysis usingmultiplatform whole-genome sequencing and analysis of multipleisolates from the German and French outbreaks. Isolates from theGerman outbreak showed remarkably little diversity, with onlytwo single nucleotide polymorphisms (SNPs) found in isolates fromfour individuals. Surprisingly, we found much greater diversity (19SNPs) in isolates from seven individuals infected in the French outbreak.The German isolates form a clade within the more diverseFrench outbreak strains. Moreover, five isolates derived from a singleinfected individual from the French outbreak had extremelylimited diversity. The striking difference in diversity between theGerman and French outbreak samples is consistent with severalhypotheses, including a bottleneck that purged diversity in theGerman isolates, variation in mutation rates in the two E. coli outbreakpopulations, or uneven distribution of diversity in the seedpopulations that led to each outbreak

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Genomic epidemiology of the Escherichia coli O104:H4 outbreaks in Europe, 2011

Grad

Lipsitch

Feldgarden

et al. 2012

Proc. Natl. Acad. Sci. U.S.A.

255

232

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“…Çocukluk çağında daha sık olduğu bilinen HÜS bu salgında çoğunlukla (%88) erişkin hastalarda saptanmıştır. Ardından Fransa'da küçük bir grup erişkin hastalarda D+HÜS saptanmıştır (4). Aynı dönemde Türkiye'de çoğunluğu Marmara bölgesinde D+HÜS vakalarının ortaya çıktığı gözlenmiştir.…”

Section: Introductionunclassified

Di̇yare Öyküsü Olan Hemoli̇ti̇k Üremi̇k Sendrom Tanili Hastalarin Kli̇ni̇k Özelli̇kleri̇

et al. 2015

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Gereç ve Yöntem: İkibinonbir yılında 9 HÜS hastası izlendi. Tam kan sayımı, periferik kan yayması, kan üre, kreatinin, elektrolitler, kompleman C3, direkt coombs testi, idrar, kan ve dışkı kültürleri ve akciğer grafisi yapıldı. Bulgular: Ortalama yaş 5,8±4,2 (3ay-12 yaş) yaştı. Altı hastada anüri mevcuttu ve ilk idrar çıkışı başvurudan 2-7 gün sonra görüldü. Ortalama hastanede yatış süresi 17,66±13,77 (8-52) gündü. İyileşme sürecinde ilk olarak trombosit sayısı yükseldi. Anürik hastalarda idrar çıkışı trombosit sayısının yükselmeye başlamasından hemen sonra görüldü. Ortalama oligüri ve anüri süresi sırasıyla 7±3 (3-10) ve 4±5 (1-14) gündü. Sonuç: Çalışmamızın sonuçları, serum C3 düzeyi düşük olan, hayati organ tutulumu gösteren, böbrek yetersizliği uzun süren ve dışkıda verotoksin negatif olan hastaların atipikHÜS nedenleri açısından tetkikleri tamamlanmamış olsa bile atipikHÜS gibi kabul edilerek tedavi edilmesinin uygun olacağını düşündürmektedir. Anahtar Kelimeler: Hemolitik üremik sendrom; HÜS; anemi; çocuk ABSTRACT Objective: Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure. The most common form of HUS in children is Shigatoxin-producing Escherichia coli (STEC) related HUS. HUS is the most common causeof acute renal failure in Europe whereas it was not observed in the same frequency in our country. However, in 2011, after the outbreak of Escherichia coli (E. Coli) gastroenteritis and HUS in Germany, we observed significantly increased cases of HUS in our country. In this retrospective study, we aimed to determine the clinical features and prognosis of HUS patients who admitted with a history of diarrhea during this breakout. MaterialsandMethods: We followed up 9 patients with diarrhea associated HUS in 2011. Blood cell count, peripheral blood smear, serum urea, creatinine, electrolytes, complement C3, direct Coombs test, cultures of urine as well as blood and stool, chest X-ray were performed. Results: The mean age was 5.8 ± 4.2 years (3 months-12 years). Six of the patients had complete anuria, the first urine appeared 2-7 days after the presentation. Mean duration of hospitalization was 17.66±13.77 days (8-52). In healing process, first platelet count increased. Urine out put appeared soon after the platelet count rose in the anuric patients, mean duration of anuria and oliguria were 7±3 days (3-10) and 4±5 days (1-14), respectively.

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