Hemolytic uremic syndrome in Belgium: incidence and association with verocytotoxin-producing Escherichia coli infection.

Cornu, Guy;Proesmans, Willem;Dediste, Anne;Jacobs, Frédérique;Lauwers, Sabine;et.al.
(1999) Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases — Vol. 5, n° 1, p. 16-22 (1999)

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  • Cornu, GuyUCLouvain
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  • Proesmans, Willem
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  • Dediste, Anne
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  • Jacobs, Frédérique
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  • Mertens, AnneUCLouvain
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  • Lauwers, Sabine
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Abstract
OBJECTIVE: To evaluate the incidence of hemolytic uremic syndrome (HUS) in Belgium and to determine the role of verocytotoxin-producing Escherichia coli O157:H7 and other serotypes (non-O157 VTEC). METHODS: Twenty-two centers, including the seven university hospitals, registered prospectively all cases of HUS; they collected clinical samples for isolation of VTEC strains and serum for detection of specific O-lipopolysaccharide antibodies. RESULTS: Forty-seven cases of HUS (including five incomplete cases) were recorded. Three cases were seen in non-residents. The incidence of complete HUS in Belgian residents was 4.3 cases/100 000 in children <5 years old, 1.8 cases/100 000 when all children <15 years were considered, and 0.42/100 000 when patients of all ages were taken into account. By combining bacteriologic and serologic results, evidence of VTEC infection was obtained in 64% of the patients, mainly but not exclusively in children with prodromal diarrhea. The 13 VTEC isolates belonged to serotypes O157:H7 (nine isolates), O26:H11, O121:H---, O145:H--- and O172:H--- (one each) and all produced VT2 (+VT2vh-a in three O157 strains) and were positive for the eaeA gene. CONCLUSIONS: The incidence rate found in this study and the high mortality and morbidity linked with this syndrome warrant further registration of pediatric and post-diarrheic adult HUS cases and also examination of stools for both O157 and non-O157 VTEC strains. For effective prevention of this disease, further study of the serotypes and accessory virulence factors associated with HUS is needed.
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Cornu, G., Proesmans, W., Dediste, A., Jacobs, F., Van De Walle, J., Mertens, A., Ramet, J., & Lauwers, S. (1999). Hemolytic uremic syndrome in Belgium: incidence and association with verocytotoxin-producing Escherichia coli infection. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 5(1), 16-22. https://hdl.handle.net/2078.5/73223 (Original work published 1999)