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Haemolytic uraemic syndrome and Shiga toxin-producing Escherichia coli infection in children in France

Published online by Cambridge University Press:  01 April 2000

B. DECLUDT
Affiliation:
Réseau National de Santé Publique, Saint-Maurice, France
P. BOUVET
Affiliation:
Unité des Entérobactéries, Institut Pasteur, Paris, France
P. MARIANI-KURKDJIAN
Affiliation:
Laboratoire de Microbiologie, Hôpital Robert Debré, Paris, France
F. GRIMONT
Affiliation:
Unité des Entérobactéries, Institut Pasteur, Paris, France
P. A. D. GRIMONT
Affiliation:
Unité des Entérobactéries, Institut Pasteur, Paris, France
B. HUBERT
Affiliation:
Réseau National de Santé Publique, Saint-Maurice, France
C. LOIRAT
Affiliation:
Service de Néphrologie, Hôpital Robert Debré, Paris, France
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Abstract

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We conducted a study to determine the incidence of haemolytic uraemic syndrome (HUS) in children in France and to assess the role of Shiga-toxin-producing Escherichia coli (STEC) infection in the aetiology of HUS. In collaboration with the Société de Néphrologie Pédiatrique we undertook a retrospective review of all cases of HUS hospitalized from January 1993 to March 1995 and a 1-year prospective study (April 1995–March 1996) of epidemiological and microbiological features of cases of HUS. The polymerase chain reaction (PCR) procedure was used to detect stx, eae, e-hlyA genes directly from case stool samples. Serum samples from cases were examined for antibodies to lipopolysaccharide (LPS) of 26 major STEC serogroups. Two hundred and eighty-six cases were reported. The average incidence per year was 0·7/105 children < 15 years and 1·8/105 children < 5 years. During the prospective study, 122/130 cases were examined for evidence of STEC infection using PCR and/or serological assays and 105 (86%) had evidence of STEC infection. Serum antibodies to E. coli O157 LPS were detected in 79 (67%) cases tested. In conclusion, this study showed that STEC infection is an important cause of HUS in children in France, with a high proportion related to the O157 serogroup.

Type
Research Article
Copyright
© 2000 Cambridge University Press