Skip to main content
NCBI home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1992 Aug;30(8):2153–2157. doi: 10.1128/jcm.30.8.2153-2157.1992

Enterohemorrhagic Escherichia coli associated with hemolytic-uremic syndrome in Chilean children.

A Cordovéz 1, V Prado 1, L Maggi 1, J Cordero 1, J Martinez 1, A Misraji 1, R Rios 1, G Soza 1, A Ojeda 1, M M Levine 1
PMCID: PMC265461  PMID: 1500525

Abstract

A clinicoepidemiological study was undertaken to determine if enterohemorrhagic Escherichia coli (EHEC) was associated with hemolytic-uremic syndrome (HUS) in children in Santiago, Valdivia, and Temuco, Chile. Prospective surveillance detected 20 hospitalized cases of HUS in children less than 4 years of age in these cities from March 1988 to March 1989. Each HUS patient was matched (by sex and age) with two control children (hospitalized elective-surgery patients). To detect EHEC, DNA from stool culture isolates of E. coli was detected by hybridization with biotin-labelled DNA probes specific for the EHEC virulence plasmid, Shiga-like toxin I (SLT-I) or SLT-II. Stool cultures from 6 of 20 cases (30%) and from 2 of 38 controls (5.3%) yielded EHEC (P = 0.0158). EHEC isolates from all HUS cases hybridized with the EHEC plasmid probe and with probes for SLT-I or -II (or both). The serogroups of the isolates included O157, O26, and O111. EHEC causes HUS in Chile, and the biotinylated gene probes are practical diagnostic tools for epidemiologic studies.

Full text

PDF
2153

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bitzan M., Karch H., Altrogge H., Strehlau J., Bläker F. Hemolytic-uremic syndrome associated with a variant Shiga-like cytotoxin of Escherichia coli O111. Pediatr Infect Dis J. 1988 Feb;7(2):128–132. doi: 10.1097/00006454-198802000-00013. [DOI] [PubMed] [Google Scholar]
  2. Bitzan M., Moebius E., Ludwig K., Müller-Wiefel D. E., Heesemann J., Karch H. High incidence of serum antibodies to Escherichia coli O157 lipopolysaccharide in children with hemolytic-uremic syndrome. J Pediatr. 1991 Sep;119(3):380–385. doi: 10.1016/s0022-3476(05)82049-9. [DOI] [PubMed] [Google Scholar]
  3. Carter A. O., Borczyk A. A., Carlson J. A., Harvey B., Hockin J. C., Karmali M. A., Krishnan C., Korn D. A., Lior H. A severe outbreak of Escherichia coli O157:H7--associated hemorrhagic colitis in a nursing home. N Engl J Med. 1987 Dec 10;317(24):1496–1500. doi: 10.1056/NEJM198712103172403. [DOI] [PubMed] [Google Scholar]
  4. Cerda M., Taboada H., Solar E., Casterán J. C., Cofré C., del Valle M., Pena S. Sindrome hemolítico urémico. Rev Chil Pediatr. 1984 Jan-Feb;55(1):29–33. [PubMed] [Google Scholar]
  5. Cerda M., Taboada H., Solar E., Casterán J. C., Cofré C., del Valle M., Pena S. Sindrome hemolítico urémico. Rev Chil Pediatr. 1984 Jan-Feb;55(1):29–33. [PubMed] [Google Scholar]
  6. Fong J. S., de Chadarevian J. P., Kaplan B. S. Hemolytic-uremic syndrome. Current concepts and management. Pediatr Clin North Am. 1982 Aug;29(4):835–856. doi: 10.1016/s0031-3955(16)34216-x. [DOI] [PubMed] [Google Scholar]
  7. GASSER C., GAUTIER E., STECK A., SIEBENMANN R. E., OECHSLIN R. Hämolytisch-urämische Syndrome: bilaterale Nierenrindennekrosen bei akuten erworbenen hämolytischen Anämien. Schweiz Med Wochenschr. 1955 Sep 20;85(38-39):905–909. [PubMed] [Google Scholar]
  8. GIANANTONIO C., VITACCO M., MENDILAHARZU F., RUTTY A., MENDILAHARZU J. THE HEMOLYTIC-UREMIC SYNDROME. J Pediatr. 1964 Apr;64:478–491. doi: 10.1016/s0022-3476(64)80337-1. [DOI] [PubMed] [Google Scholar]
  9. Gianantonio C. A., Vitacco M., Mendilaharzu F., Gallo G. E., Sojo E. T. The hemolytic-uremic syndrome. Nephron. 1973;11(2):174–192. doi: 10.1159/000180229. [DOI] [PubMed] [Google Scholar]
  10. Gicquelais K. G., Baldini M. M., Martinez J., Maggi L., Martin W. C., Prado V., Kaper J. B., Levine M. M. Practical and economical method for using biotinylated DNA probes with bacterial colony blots to identify diarrhea-causing Escherichia coli. J Clin Microbiol. 1990 Nov;28(11):2485–2490. doi: 10.1128/jcm.28.11.2485-2490.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gransden W. R., Damm M. A., Anderson J. D., Carter J. E., Lior H. Further evidence associating hemolytic uremic syndrome with infection by Verotoxin-producing Escherichia coli O157:H7. J Infect Dis. 1986 Sep;154(3):522–524. doi: 10.1093/infdis/154.3.522. [DOI] [PubMed] [Google Scholar]
  12. Karch H., Heesemann J., Laufs R., O'Brien A. D., Tacket C. O., Levine M. M. A plasmid of enterohemorrhagic Escherichia coli O157:H7 is required for expression of a new fimbrial antigen and for adhesion to epithelial cells. Infect Immun. 1987 Feb;55(2):455–461. doi: 10.1128/iai.55.2.455-461.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Karmali M. A. Infection by verocytotoxin-producing Escherichia coli. Clin Microbiol Rev. 1989 Jan;2(1):15–38. doi: 10.1128/cmr.2.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Karmali M. A., Petric M., Lim C., Fleming P. C., Arbus G. S., Lior H. The association between idiopathic hemolytic uremic syndrome and infection by verotoxin-producing Escherichia coli. J Infect Dis. 1985 May;151(5):775–782. doi: 10.1093/infdis/151.5.775. [DOI] [PubMed] [Google Scholar]
  15. Karmali M. A., Steele B. T., Petric M., Lim C. Sporadic cases of haemolytic-uraemic syndrome associated with faecal cytotoxin and cytotoxin-producing Escherichia coli in stools. Lancet. 1983 Mar 19;1(8325):619–620. doi: 10.1016/s0140-6736(83)91795-6. [DOI] [PubMed] [Google Scholar]
  16. Kleanthous H., Smith H. R., Scotland S. M., Gross R. J., Rowe B., Taylor C. M., Milford D. V. Haemolytic uraemic syndromes in the British Isles, 1985-8: association with verocytotoxin producing Escherichia coli. Part 2: Microbiological aspects. Arch Dis Child. 1990 Jul;65(7):722–727. doi: 10.1136/adc.65.7.722. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Levine M. M. Escherichia coli that cause diarrhea: enterotoxigenic, enteropathogenic, enteroinvasive, enterohemorrhagic, and enteroadherent. J Infect Dis. 1987 Mar;155(3):377–389. doi: 10.1093/infdis/155.3.377. [DOI] [PubMed] [Google Scholar]
  18. Levine M. M., Xu J. G., Kaper J. B., Lior H., Prado V., Tall B., Nataro J., Karch H., Wachsmuth K. A DNA probe to identify enterohemorrhagic Escherichia coli of O157:H7 and other serotypes that cause hemorrhagic colitis and hemolytic uremic syndrome. J Infect Dis. 1987 Jul;156(1):175–182. doi: 10.1093/infdis/156.1.175. [DOI] [PubMed] [Google Scholar]
  19. Loirat C., Sonsino E., Varga Moreno A., Pillion G., Mercier J. C., Beaufils F., Mathieu H. Hemolytic-uremic syndrome: an analysis of the natural history and prognostic features. Acta Paediatr Scand. 1984 Jul;73(4):505–514. doi: 10.1111/j.1651-2227.1984.tb09962.x. [DOI] [PubMed] [Google Scholar]
  20. Lopez E. L., Diaz M., Grinstein S., Devoto S., Mendilaharzu F., Murray B. E., Ashkenazi S., Rubeglio E., Woloj M., Vasquez M. Hemolytic uremic syndrome and diarrhea in Argentine children: the role of Shiga-like toxins. J Infect Dis. 1989 Sep;160(3):469–475. doi: 10.1093/infdis/160.3.469. [DOI] [PubMed] [Google Scholar]
  21. Martin D. L., MacDonald K. L., White K. E., Soler J. T., Osterholm M. T. The epidemiology and clinical aspects of the hemolytic uremic syndrome in Minnesota. N Engl J Med. 1990 Oct 25;323(17):1161–1167. doi: 10.1056/NEJM199010253231703. [DOI] [PubMed] [Google Scholar]
  22. Neill M. A., Agosti J., Rosen H. Hemorrhagic colitis with Escherichia coli O157:H7 preceding adult hemolytic uremic syndrome. Arch Intern Med. 1985 Dec;145(12):2215–2217. [PubMed] [Google Scholar]
  23. Neill M. A., Tarr P. I., Clausen C. R., Christie D. L., Hickman R. O. Escherichia coli O157:H7 as the predominant pathogen associated with the hemolytic uremic syndrome: a prospective study in the Pacific Northwest. Pediatrics. 1987 Jul;80(1):37–40. [PubMed] [Google Scholar]
  24. Newland J. W., Neill R. J. DNA probes for Shiga-like toxins I and II and for toxin-converting bacteriophages. J Clin Microbiol. 1988 Jul;26(7):1292–1297. doi: 10.1128/jcm.26.7.1292-1297.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Pavia A. T., Nichols C. R., Green D. P., Tauxe R. V., Mottice S., Greene K. D., Wells J. G., Siegler R. L., Brewer E. D., Hannon D. Hemolytic-uremic syndrome during an outbreak of Escherichia coli O157:H7 infections in institutions for mentally retarded persons: clinical and epidemiologic observations. J Pediatr. 1990 Apr;116(4):544–551. doi: 10.1016/s0022-3476(05)81600-2. [DOI] [PubMed] [Google Scholar]
  26. Remis R. S., MacDonald K. L., Riley L. W., Puhr N. D., Wells J. G., Davis B. R., Blake P. A., Cohen M. L. Sporadic cases of hemorrhagic colitis associated with Escherichia coli O157:H7. Ann Intern Med. 1984 Nov;101(5):624–626. doi: 10.7326/0003-4819-101-5-624. [DOI] [PubMed] [Google Scholar]
  27. Riley L. W., Remis R. S., Helgerson S. D., McGee H. B., Wells J. G., Davis B. R., Hebert R. J., Olcott E. S., Johnson L. M., Hargrett N. T. Hemorrhagic colitis associated with a rare Escherichia coli serotype. N Engl J Med. 1983 Mar 24;308(12):681–685. doi: 10.1056/NEJM198303243081203. [DOI] [PubMed] [Google Scholar]
  28. Rivas M., Voyer L. E., Tous M. I., Leardini N. A., de Mena M. F., Quadri B., Wainsztein R. Detección de Escherichia coli O157 productor de verotoxina en pacientes con síndrome urémico hemolítico. Medicina (B Aires) 1990;50(6):571–571. [PubMed] [Google Scholar]
  29. Scotland S. M., Smith H. R., Rowe B. Two distinct toxins active on Vero cells from Escherichia coli O157. Lancet. 1985 Oct 19;2(8460):885–886. doi: 10.1016/s0140-6736(85)90146-1. [DOI] [PubMed] [Google Scholar]
  30. Spika J. S., Parsons J. E., Nordenberg D., Wells J. G., Gunn R. A., Blake P. A. Hemolytic uremic syndrome and diarrhea associated with Escherichia coli O157:H7 in a day care center. J Pediatr. 1986 Aug;109(2):287–291. doi: 10.1016/s0022-3476(86)80386-9. [DOI] [PubMed] [Google Scholar]
  31. Strockbine N. A., Marques L. R., Newland J. W., Smith H. W., Holmes R. K., O'Brien A. D. Two toxin-converting phages from Escherichia coli O157:H7 strain 933 encode antigenically distinct toxins with similar biologic activities. Infect Immun. 1986 Jul;53(1):135–140. doi: 10.1128/iai.53.1.135-140.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Tarr P. I., Neill M. A., Clausen C. R., Watkins S. L., Christie D. L., Hickman R. O. Escherichia coli O157:H7 and the hemolytic uremic syndrome: importance of early cultures in establishing the etiology. J Infect Dis. 1990 Aug;162(2):553–556. doi: 10.1093/infdis/162.2.553. [DOI] [PubMed] [Google Scholar]
  33. Tzipori S., Karch H., Wachsmuth K. I., Robins-Browne R. M., O'Brien A. D., Lior H., Cohen M. L., Smithers J., Levine M. M. Role of a 60-megadalton plasmid and Shiga-like toxins in the pathogenesis of infection caused by enterohemorrhagic Escherichia coli O157:H7 in gnotobiotic piglets. Infect Immun. 1987 Dec;55(12):3117–3125. doi: 10.1128/iai.55.12.3117-3125.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Tzipori S., Wachsmuth K. I., Smithers J., Jackson C. Studies in gnotobiotic piglets on non-O157:H7 Escherichia coli serotypes isolated from patients with hemorrhagic colitis. Gastroenterology. 1988 Mar;94(3):590–597. doi: 10.1016/0016-5085(88)90228-4. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES