Hemolytic uremic syndrome due to Shiga toxin-producing Escherichia coli infection.

The leading cause of hemolytic uremic syndrome (HUS) in children is Shiga toxin-producing Escherichia coli (STEC) infection, which has a major outbreak potential. Since the early 2010s, STEC epidemiology is characterized by a decline of the historically predominant O157 serogroup and the emergence of non-O157 STEC, especially O26 and O80 in France. STEC contamination occurs through the ingestion of contaminated food or water, person-to-person transmission, or contact with ruminants or their contaminated environment. The main symptom is diarrhea, which is bloody in about 60% of patients and occurs after a median incubation period of three days. Shiga toxins released by STEC induce a cascade of thrombogenic and inflammatory changes of microvascular endothelial cells. HUS is observed in 5-15% of STEC infection cases, defined by the triad of mechanical hemolytic anemia, thrombocytopenia, and acute renal injury. The diagnosis of STEC infection relies on biological screening for Shiga toxins and STEC in stools and serology. Treatment of STEC-HUS is mainly symptomatic, as no specific drug has proved effective. The effect of antibiotics in STEC infection and STEC-HUS remains debated; however, some bacteriostatic antibiotics might have a beneficial effect. Proofs of evidence of a benefit from complement blockade therapy in STEC-HUS are also lacking. Clinical and bacteriological STEC-HUS surveillance needs to be continued. Ongoing prospective studies will document the role of bacteriostatic antibiotics in STEC infection and STEC-HUS, and of complement blockade therapy in STEC-HUS.

Bruyand M ，Mariani-Kurkdjian P ，Gouali M ，de Valk H ，King LA ，Le Hello S ，Bonacorsi S ，Loirat C ... -  《-》

Paediatric haemolytic uraemic syndrome related to Shiga toxin-producing Escherichia coli, an overview of 10 years of surveillance in France, 2007 to 2016.

Bruyand M ，Mariani-Kurkdjian P ，Le Hello S ，King LA ，Van Cauteren D ，Lefevre S ，Gouali M ，Jourdan-da Silva N ，Mailles A ，Donguy MP ，Loukiadis E ，Sergentet-Thevenot D ，Loirat C ，Bonacorsi S ，Weill FX ，De Valk H ，Réseau français hospitalier de surveillance du SHU pédiatrique ... -  《Eurosurveillance》

Surveillance of hemolytic uremic syndrome in children less than 15 years of age, a system to monitor O157 and non-O157 Shiga toxin-producing Escherichia coli infections in France, 1996-2006.

Espié E ，Grimont F ，Mariani-Kurkdjian P ，Bouvet P ，Haeghebaert S ，Filliol I ，Loirat C ，Decludt B ，Minh NN ，Vaillant V ，de Valk H ... -  《PEDIATRIC INFECTIOUS DISEASE JOURNAL》

Unusual severe case of hemolytic uremic syndrome due to Shiga toxin 2d-producing E. coli O80:H2.

Wijnsma KL ，Schijvens AM ，Rossen JWA ，Kooistra-Smid AMDM ，Schreuder MF ，van de Kar NCAJ ... -  《-》

Comparative Genomics of Shiga Toxin-Producing Escherichia coli Strains Isolated from Pediatric Patients with and without Hemolytic Uremic Syndrome from 2000 to 2016 in Finland.

Bai X ，Ylinen E ，Zhang J ，Salmenlinna S ，Halkilahti J ，Saxen H ，Narayanan A ，Jahnukainen T ，Matussek A ... -  《Microbiology Spectrum》