ArticleBMC infectious diseases2015
Shiga toxin-producing escherichia coli infections in Norway, 1992-2012: characterization of isolates and identification of risk factors for haemolytic uremic syndrome.
Article in BMC infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
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47 citing papers in PubMed, 89 citations in OpenAlex.
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- INM004: Polyclonal Neutralizing Antibodies Against Shiga Toxin as a Treatment for Hemolytic Uremic Syndrome.Toxins · 2025Review
- Case-Control Study of Factors Associated with Hemolytic Uremic Syndrome among Shiga Toxin-Producing Escherichia coli Patients, Ireland, 2017-2020.Emerging infectious diseases · 2025Article
- Pathogenic Factors and Recent Study on the Rapid Detection of Shiga Toxin-Producing Escherichia coli (STEC).Molecular biotechnology · 2025Review
- Microbiota and metabolome dynamics induced by Shiga toxin-producingMicrobial cell (Graz, Austria) · 2025Article
- An anti-Shiga toxin VHH nanobody multimer protects mice against fatal toxicosis when administered intramuscularly as repRNA.Infection and immunity · 2024Article
- Impact of Western Diet on EnterohemorrhagicNutrients · 2024Article
- Prevalence of Shiga Toxin-ProducingAnimals : an open access journal from MDPI · 2023Article
- Genome-wide association study of hemolytic uremic syndrome causing Shiga toxin-producing Escherichia coli from Sweden, 1994-2018.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
- The Epidemiological and Clinical Characteristics of the Largest Outbreak of EnterohemorrhagicJournal of Korean medical science · 2023Article
- Alteration of a Shiga toxin-encoding phage associated with a change in toxin production level and disease severity inMicrobial genomics · 2023Article
- The Ability of Shiga Toxin-ProducingFoods (Basel, Switzerland) · 2022Article
- Shiga Toxin Subtypes, Serogroups, Phylogroups, RAPD Genotypic Diversity, and Select Virulence Markers of Shiga-ToxigenicMicroorganisms · 2022Article
- Review ofInfection and drug resistance · 2022Review
- Genome structural variation inMicrobial genomics · 2021Article
- Hemolytic uremic syndrome associated with Shiga toxin-producing Escherichia coli infection in Argentina: update of serotypes and genotypes and their relationship with severity of the disease.Pediatric nephrology (Berlin, Germany) · 2021Article
- Review
- Characterization of Shiga Toxin 2a Encoding Bacteriophages Isolated From High-Virulent O145:H25 Shiga Toxin-ProducingFrontiers in microbiology · 2021Article
- Shiga Toxin-Associated Hemolytic Uremic Syndrome in Adults, France, 2009-2017.Emerging infectious diseases · 2021Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShiga toxin-producing E. coli (STEC) infection is associated with haemolytic uremic syndrome (HUS). Therefore Norway has implemented strict guidelines for prevention and control of STEC infection. However, only a subgroup of STEC leads to HUS. Thus, identification of determinants differentiating high risk STEC (HUS STEC) from low risk STEC (non-HUS STEC) is needed to enable implementation of graded infectious disease response.
methodsA national study of 333 STEC infections in Norway, including one STEC from each patient or outbreak over two decades (1992-2012), was conducted. Serotype, virulence profile, and genotype of each STEC were determined by phenotypic or PCR based methods. The association between microbiological properties and demographic and clinical data was assessed by univariable analyses and multiple logistic regression models.
resultsFrom 1992 through 2012, an increased number of STEC cases including more domestically acquired infections were notified in Norway. O157 was the most frequent serogroup (33.6 %), although a decrease of this serogroup was seen over the last decade. All 25 HUS patients yielded STEC with stx2, eae, and ehxA. In a multiple logistic regression model, age ≤5 years (OR = 16.7) and stx2a (OR = 30.1) were independently related to increased risk of HUS. eae and hospitalization could not be modelled since all HUS patients showed these traits. The combination of low age (≤5 years) and the presence of stx2a, and eae gave a positive predictive value (PPV) for HUS of 67.5 % and a negative predictive value (NPV) of 99.0 %. SF O157:[H7] and O145:H?, although associated with HUS in the univariable analyses, were not independent risk factors. stx1 (OR = 0.1) was the sole factor independently associated with a reduced risk of HUS (NPV: 79.7 %); stx2c was not so.
conclusionsOur results indicate that virulence gene profile and patients' age are the major determinants of HUS development.
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