Laura F Alconcher1, Alejandro Balestracci2, Paula A Coccia3, Angela Del C Suarez4, Flavia B Ramírez5, Marta L Monteverde6, María Graciela Perez Y Gutiérrez7, Paula M Carlopio8, Illiana Principi9, Patricia Estrella10, Susana Micelli11, Daniela C Leroy12, Nahir E Quijada13, Claudia Seminara14, Marta I Giordano15, Susana B Hidalgo Solís16, Mariana Saurit17, Alejandra Caminitti18, Andrea Arias19, Miguel Liern20, Marta Rivas21. 1. Pediatric Nephrology Unit, Pediatric Department, Hospital Interzonal Dr. José Penna Bahía Blanca, Las Lomas 217, (8000) Bahía Blanca, Buenos Aires, Argentina. laura.alconcher.la@gmail.com. 2. Nephrology Unit, Hospital General de Niños Pedro de Elizalde CABA, Buenos Aires, Argentina. 3. Pediatric Nephrology Division, Department of Pediatrics, Hospital Italiano Ciudad Autónoma de Buenos Aires (CABA), Buenos Aires, Argentina. 4. Department of Nephrology, Hospital de Niños Sor María Ludovica La Plata, Buenos Aires, Argentina. 5. Pediatric Nephrology Division, Department of Pediatrics, Hospital Dr. Castro Rendon Neuquén, Neuquén, Argentina. 6. Hospital Nacional de Pediatría JP Garrahan CABA, Buenos Aires, Argentina. 7. Department of Nephrology, Hospital de Niños San Justo, Buenos Aires, Argentina. 8. Pediatric Nephrology Division, Department of Pediatrics, Hospital Posadas, Buenos Aires, Argentina. 9. Department of Nephrology, Hospital Pediátrico Humberto J Notti Mendoza, Mendoza, Argentina. 10. Dirección de Epidemiología de La Pampa - Hospital Lucio Molas, Santa Rosa, La Pampa, Argentina. 11. Department of Nephrology, Hospital del Niño Jesús, San Miguel de Tucumán, Tucumán, Argentina. 12. Department of Pediatrics, Hospital Interzonal de Agudos Abrahan Piñeyro Junín, Buenos Aires, Argentina. 13. Hospital Infantil Municipal Córdoba, Córdoba, Argentina. 14. Hospital Provincial de Córdoba, Córdoba, Argentina. 15. Complejo Sanitario San Luis, San Luis, Argentina. 16. Department of Nephrology, Hospital Juan Pablo II, Corrientes, Argentina. 17. Hospital Público Materno Infantil de Salta, Salta, Argentina. 18. Department of Nephrology, Hospital Provincial de Santa Fé, Santa Fé, Argentina. 19. Department of Nephrology, Hospital Materno Infantil Dr. Héctor Quintana Jujuy, San Salvador de Jujuy, Argentina. 20. Department of Nephrology, Hospital Gutiérrez CABA, Buenos Aires, Argentina. 21. Instituto Nacional de Enfermedades Infecciosas-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina.
Abstract
BACKGROUND: Shiga toxin-producing Escherichia coli (STEC) infection is the most common cause of hemolytic uremic syndrome (HUS). Only few studies correlated serotypes and stx genotypes with disease severity. This study aimed to update STEC serotypes, stx genotypes, and virulence factors (eae and ehxA) in a cohort of patients with STEC-HUS and investigate whether they influence the severity of disease. METHODS: In this multicentric study, children hospitalized between 2005 and 2016 with STEC-HUS confirmed by the National Reference Laboratory were included. Serotypes (O157, O145, O121, and others), stx genotypes (stx1a, stx2a, stx2c, stx2d, and others), and virulence factors were analyzed, and their association with dialysis requirement (>10 days); severe neurological, cardiovascular, and/or bowel involvement; and death was assessed. RESULTS: The records of 280 patients were reviewed; 160 females, median age 21 months (IQR18m). STEC O157 was isolated in 206 (73.6%) patients, O145 in 47 (16.8%), O121 in 15 (5.4%), and other serotypes in 12 (4.2%). The stx2a/2c genotype was carried by 179 (63.9%) strains, stx2a by 94 (33.6%), stx1a/stx2a by five (1.8%), and stx1a only by two (0.7%). All strains except six harbored eae and ehxA genes. Fifty-nine (21.1%) patients had severe neurological involvement, 29 (10.4%) severe bowel injury, 14 (5%) cardiovascular involvement, 53 (18.9%) required > 10 days of dialysis, and 12 (4.3%) died. Neither serotypes nor stx genotypes detected were significantly linked to severity. CONCLUSIONS: Serotype O157 and virulence stx2a/2c, eae, ehxA genotype are prevalent in Argentina, and no relationship was found between severity and serotypes and genotypes of STEC detected.
BACKGROUND: Shiga toxin-producing Escherichia coli (STEC) infection is the most common cause of hemolytic uremic syndrome (HUS). Only few studies correlated serotypes and stx genotypes with disease severity. This study aimed to update STEC serotypes, stx genotypes, and virulence factors (eae and ehxA) in a cohort of patients with STEC-HUS and investigate whether they influence the severity of disease. METHODS: In this multicentric study, children hospitalized between 2005 and 2016 with STEC-HUS confirmed by the National Reference Laboratory were included. Serotypes (O157, O145, O121, and others), stx genotypes (stx1a, stx2a, stx2c, stx2d, and others), and virulence factors were analyzed, and their association with dialysis requirement (>10 days); severe neurological, cardiovascular, and/or bowel involvement; and death was assessed. RESULTS: The records of 280 patients were reviewed; 160 females, median age 21 months (IQR18m). STEC O157 was isolated in 206 (73.6%) patients, O145 in 47 (16.8%), O121 in 15 (5.4%), and other serotypes in 12 (4.2%). The stx2a/2c genotype was carried by 179 (63.9%) strains, stx2a by 94 (33.6%), stx1a/stx2a by five (1.8%), and stx1a only by two (0.7%). All strains except six harbored eae and ehxA genes. Fifty-nine (21.1%) patients had severe neurological involvement, 29 (10.4%) severe bowel injury, 14 (5%) cardiovascular involvement, 53 (18.9%) required > 10 days of dialysis, and 12 (4.3%) died. Neither serotypes nor stx genotypes detected were significantly linked to severity. CONCLUSIONS: Serotype O157 and virulence stx2a/2c, eae, ehxA genotype are prevalent in Argentina, and no relationship was found between severity and serotypes and genotypes of STEC detected.
Authors: Cynthia A Fuller; Christine A Pellino; Michael J Flagler; Jane E Strasser; Alison A Weiss Journal: Infect Immun Date: 2011-01-03 Impact factor: 3.441
Authors: Laura F Alconcher; Paula A Coccia; Angela Del C Suarez; Marta L Monteverde; María Graciela Perez Y Gutiérrez; Paula M Carlopio; Mabel L Missoni; Alejandro Balestracci; Illiana Principi; Flavia B Ramírez; Patricia Estrella; Susana Micelli; Daniela C Leroy; Nahir E Quijada; Claudia Seminara; Marta I Giordano; Susana B Hidalgo Solís; Mariana Saurit; Alejandra Caminitti; Andrea Arias; Marta Rivas; Paula Risso; Miguel Liern Journal: Pediatr Nephrol Date: 2018-06-30 Impact factor: 3.714
Authors: Elisa Ylinen; Saara Salmenlinna; Jani Halkilahti; Timo Jahnukainen; Linda Korhonen; Tiia Virkkala; Ruska Rimhanen-Finne; Matti Nuutinen; Janne Kataja; Pekka Arikoski; Laura Linkosalo; Xiangning Bai; Andreas Matussek; Hannu Jalanko; Harri Saxén Journal: Pediatr Nephrol Date: 2020-04-22 Impact factor: 3.714
Authors: Lin T Brandal; Astrid L Wester; Heidi Lange; Inger Løbersli; Bjørn-Arne Lindstedt; Line Vold; Georg Kapperud Journal: BMC Infect Dis Date: 2015-08-11 Impact factor: 3.090
Authors: Clara Berdasco; Alipio Pinto; Mariano G Blake; Fernando Correa; Nadia A Longo Carbajosa; Ana B Celi; Patricia A Geoghegan; Adriana Cangelosi; Myriam Nuñez; Mariela M Gironacci; Jorge Goldstein Journal: Cell Mol Neurobiol Date: 2022-10-13 Impact factor: 4.231