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Hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli in children: incidence, risk factors, and clinical outcome.
Ylinen, Elisa; Salmenlinna, Saara; Halkilahti, Jani; Jahnukainen, Timo; Korhonen, Linda; Virkkala, Tiia; Rimhanen-Finne, Ruska; Nuutinen, Matti; Kataja, Janne; Arikoski, Pekka; Linkosalo, Laura; Bai, Xiangning; Matussek, Andreas; Jalanko, Hannu; Saxén, Harri.
Afiliación
  • Ylinen E; Department of Pediatric Nephrology and Transplantation, New Children's Hospital, University of Helsinki and Helsinki University Hospital|, P.O. Box 347, 00029 HUS, Helsinki, Finland. elisa.ylinen@hus.fi.
  • Salmenlinna S; Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
  • Halkilahti J; Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
  • Jahnukainen T; Department of Pediatric Nephrology and Transplantation, New Children's Hospital, University of Helsinki and Helsinki University Hospital|, P.O. Box 347, 00029 HUS, Helsinki, Finland.
  • Korhonen L; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
  • Virkkala T; PEDEGO Research Unit, Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Medical Research Center Oulu (MRC Oulu), Oulu, Finland.
  • Rimhanen-Finne R; Department of Pediatric Nephrology and Transplantation, New Children's Hospital, University of Helsinki and Helsinki University Hospital|, P.O. Box 347, 00029 HUS, Helsinki, Finland.
  • Nuutinen M; Department of Health Security, Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
  • Kataja J; Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
  • Arikoski P; PEDEGO Research Unit, Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology, Medical Research Center Oulu (MRC Oulu), Oulu, Finland.
  • Linkosalo L; Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland.
  • Bai X; Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
  • Matussek A; Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
  • Jalanko H; Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska University Laboratory, Stockholm, Sweden.
  • Saxén H; Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska University Laboratory, Stockholm, Sweden.
Pediatr Nephrol ; 35(9): 1749-1759, 2020 09.
Article en En | MEDLINE | ID: mdl-32323005
BACKGROUND: Hemolytic uremic syndrome (HUS) is a multisystemic disease. In a nationwide study, we characterized the incidence, clinical course, and prognosis of HUS caused by Shiga toxin (Stx)-producing Escherichia coli (STEC) strains with emphasis on risk factors, disease severity, and long-term outcome. METHODS: The data on pediatric HUS patients from 2000 to 2016 were collected from the medical records. STEC isolates from fecal cultures of HUS and non-HUS patients were collected from the same time period and characterized by whole genome sequencing analysis. RESULTS: Fifty-eight out of 262 culture-positive cases developed verified (n = 58, 22%) STEC-HUS. Another 29 cases had probable STEC-HUS, the annual incidence of STEC-HUS being 0.5 per 100,000 children. Eleven different serogroups were detected, O157 being the most common (n = 37, 66%). Age under 3 years (OR 2.4), stx2 (OR 9.7), and stx2a (OR 16.6) were found to be risk factors for HUS. Fifty-five patients (63%) needed dialysis. Twenty-nine patients (33%) developed major neurological symptoms. Complete renal recovery was observed in 57 patients after a median 4.0 years of follow-up. Age under 3 years, leukocyte count over 20 × 109/L, and need for dialysis were predictive factors for poor renal outcome. CONCLUSIONS: Age under 3 years, stx2, and stx2a were risk factors for HUS in STEC-positive children. However, serogroup or stx types did not predict the renal outcome or major CNS symptoms.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome Hemolítico-Urémico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Pediatr Nephrol Asunto de la revista: NEFROLOGIA / PEDIATRIA Año: 2020 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Síndrome Hemolítico-Urémico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Pediatr Nephrol Asunto de la revista: NEFROLOGIA / PEDIATRIA Año: 2020 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Alemania