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.