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

Abstract

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 > or = 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.

Phage-based biocontrol strategies to reduce foodborne pathogens in foods

“…This bacterial pathogen causes a myriad of foodborne disease manifestations, including diarrhea, hemorrhagic colitis, hemolytic uremic syndrome and thrombotic thrombocytopenic purpura. 12,13 Cattle and other ruminants are considered to be the principal reservoirs of E. coli O157:H7, 14 and the contents of the intestines and fecal material on the hide ©2 0 1 1 L a n d e s B i o s c i e n c e .…”

Thrombotic Thrombocytopenic Purpura

“…In cases of suspected diarrhea or Shiga-toxin producing bacteria on sorbitol-MacConkey agar [22]. There are serological tests to detect the antibodies against the toxin and they are more sensitive compared to cultures but so far they are used only in research laboratories [23,24]. Patients with suspected atypical diarrhoea negative HUS can be tested for complement regulatory proteins like Complement Factor H (CFH), Complement Factor I (CFI) and Membrane Receptor Protein (MCP).…”

Compromiso cerebrovascular agudo en síndrome hemolítico urémico: descripción de dos casos pediátricos

“…La triada de falla renal aguda, anemia hemolítica y trombocitopenia es distintiva y constituye la base del diagnóstico. La fisiopatología subyacente tiene como eje central el desarrollo de una microangiopatía trombótica que desencadena un desorden multisistémico con alteraciones hemodinámicas que pueden comprometer el sistema nervioso central (SNC) además de tractos gastrointestinales, páncreas, hígado y riñón [1][2][3][4] .…”

“…La triada de falla renal aguda, anemia hemolítica y trombocitopenia es distintiva y constituye la base del diagnóstico. La fisiopatología subyacente tiene como eje central el desarrollo de una microangiopatía trombótica que desencadena un desorden multisistémico con alteraciones hemodinámicas que pueden comprometer el sistema nervioso central (SNC) además de tractos gastrointestinales, páncreas, hígado y riñón [1][2][3][4] .El compromiso neurológico asociado al SHU+D, ocurre en el 35 a 50% de los casos. En su patogé-nesis influyen la disfunción endotelial (mediada por la activación de la cascada del complemento inducida por la Stx), la hipertensión arterial y alteraciones hidroelectrolíticas (frecuentemente hiponatremia).…”