Virulence factors for hemolytic uremic syndrome, Denmark

Emerg Infect Dis. 2004 May;10(5):842-7. doi: 10.3201/eid1005.030576.

Abstract

We present an analysis of strain and patient factors associated with the development of bloody diarrhea and hemolytic uremic syndrome (HUS) among Shiga toxin-producing Escherichia coli (STEC) patients registered in Denmark in a 6-year period. Of 343 STEC patients, bloody diarrhea developed in 36.4% and HUS in 6.1%. In a multivariate logistic regression model, risk factors for bloody diarrhea were the eae and stx2 genes, O groups O157 and O103, and increasing age. Risk factors for HUS were presence of the stx2 (odds ratio [OR] 18.9) and eae (OR undefined) genes, being a child, and having bloody diarrhea. O group O157, although associated with HUS in a univariate analysis (OR 4.0), was not associated in the multivariate analysis (OR 1.1). This finding indicates that, rather than the O group, the combined presence of the eae and stx2 genes is an important predictor of HUS.

MeSH terms

  • Adhesins, Bacterial / genetics
  • Age Factors
  • Carrier Proteins / genetics
  • Child
  • Child, Preschool
  • Denmark
  • Diarrhea / physiopathology
  • Diarrhea / virology
  • Escherichia coli / genetics
  • Escherichia coli / metabolism
  • Escherichia coli / pathogenicity*
  • Escherichia coli Infections / physiopathology
  • Escherichia coli Infections / virology
  • Escherichia coli Proteins / genetics
  • Hemolytic-Uremic Syndrome / physiopathology*
  • Hemolytic-Uremic Syndrome / virology
  • Humans
  • Infant
  • Risk Factors
  • Shiga Toxin 2 / genetics
  • Virulence Factors* / genetics

Substances

  • Adhesins, Bacterial
  • Carrier Proteins
  • Escherichia coli Proteins
  • Shiga Toxin 2
  • Virulence Factors
  • eaeA protein, E coli