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The role of Escherichia coli O 157 infections in the classical (enteropathic) haemolytic uraemic syndrome: Results of a Central European, multicentre study

Published online by Cambridge University Press:  19 October 2009

M. Bitzan ,
K. Ludwig ,
M. Klemt ,
H. König ,
J. Büren  and
D. E. Müller-Wiefel
M. Bitzan
Affiliation:
Kinderklinik, Universitätskrankenhaus Hamburg-Eppendorf, Martinistraβe 52, D-2000 Hamburg 20, Federal Republic of Germany
K. Ludwig
Affiliation:
Kinderklinik, Universitätskrankenhaus Hamburg-Eppendorf, Martinistraβe 52, D-2000 Hamburg 20, Federal Republic of Germany
M. Klemt
Affiliation:
Kinderklinik, Universitätskrankenhaus Hamburg-Eppendorf, Martinistraβe 52, D-2000 Hamburg 20, Federal Republic of Germany
H. König
Affiliation:
Kinderklinik, Universitätskrankenhaus Hamburg-Eppendorf, Martinistraβe 52, D-2000 Hamburg 20, Federal Republic of Germany
J. Büren
Affiliation:
Kinderklinik, Universitätskrankenhaus Hamburg-Eppendorf, Martinistraβe 52, D-2000 Hamburg 20, Federal Republic of Germany
D. E. Müller-Wiefel
Affiliation:
Kinderklinik, Universitätskrankenhaus Hamburg-Eppendorf, Martinistraβe 52, D-2000 Hamburg 20, Federal Republic of Germany
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To assess the importance of infection by Verotoxin (VT) producing Escherichia coli (VTEC) in children with HUS in Central Europe, stool and/or serum samples obtained from 147 patients from 28 paediatric centres were prospectively examined for the presence of VTEC and the kinetics of faecal VT titres (FVT), and for VT neutralization titres and antibodies against E. coli O 157 lipopolysaccharide, respectively. Ninety-two percent of the patients had classic (enteropathic) HUS (E+ HUS). Evidence of VTEC infection was obtained in 86% of them. VTEC/FVT were identified in 55/118 E+ cases (47%). A prominent feature was the frequent isolation of sorbitol-fermenting, VT2-producing E. coli O 157. H−. VT1 (C600/H19) was neutralized by 9%, and VT2 (C600/933W) by 99% of the initial serum samples from E+ patients, compared to 3% (VT1) and 100% (VT2) from age-related controls. Fourfold titre rises against VT1 and/or VT2 were observed in 13/70 (19%), and significantly elevated O 157 LPS IgM and/or IgA antibodies in 106/128 (83%) of the E+ patients. The ubiquitous VT2 neutralizing principle in the serum of HUS patients as of healthy controls warrants further investigations.

Type
Research Article
Information
Epidemiology & Infection , Volume 110 , Issue 2 , April 1993 , pp. 183 - 196
Copyright
Copyright © Cambridge University Press 1993

References

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