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J Pediatr Gastroenterol Nutr. 2014 Aug;59(2):218-20. doi: 10.1097/MPG.0000000000000420.

Co-infection in children with bloody diarrhea caused by Shiga toxin-producing Escherichia coli: data of the North Italian HUS Network.

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*Center for HUS Prevention, Control and Management †Unit of Microbiology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.


Hemolytic-uremic syndrome (HUS) is an important cause of acute kidney injury in children often caused by Shiga toxin-producing Escherichia coli (STEC) enterocolitis. In a screening program for STEC infection in children with bloody diarrhea in northern Italy for early diagnosis of HUS, co-infection with Salmonella or Campylobacter was documented in as many as 35.6% of Shiga toxin-positive patients. It is speculated that infection by Salmonella or Campylobacter may increase the risk of STEC enterocolitis and therefore of HUS. The isolation of microorganisms (other then STEC) in HUS should not be necessarily regarded as the etiological agent for the thrombotic microangiopathy.

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