Observational studyBMJ open2016
Disease severity of Shiga toxin-producing E. coli O157 and factors influencing the development of typical haemolytic uraemic syndrome: a retrospective cohort study, 2009-2012.
Observational study in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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Who cites it
44 citing papers in PubMed, 66 citations in OpenAlex.
- GBP1 recruitment to actin-rich pedestals of extracellular Gram-negative bacteria promotes pyroptosis.The EMBO journal · 2026Article
- A comparison of using online market panel members and traditional methods in control recruitment for a case-control study during a national outbreak of STEC O145, United Kingdom.Epidemiology and infection · 2026Article
- Shiga Toxin-Producing Escherichia coli Outbreak in Canadian Daycare Centers.JAMA network open · 2026Article
- Mind the gap! TypingMicrobial genomics · 2026Article
- An outbreak of Shiga toxin-producingEpidemiology and infection · 2026Article
- Predicting clinical outcome ofMicrobial genomics · 2025Article
- GBP1 recruitment to actin-rich pedestals induced by extracellular Gram negative bacteria promotes pyroptosis.bioRxiv : the preprint server for biology · 2025Article
- Milk and meat safety in Nepal: addressing challenges and exploring solutions.Science in One Health · 2025Review
- An outbreak of Shiga toxin-producingEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024Article
- Facilitators and barriers to implementing successful exclusion among children with shiga toxin-producing Escherichia coli: a qualitative analysis of public health case management records.BMC public health · 2024Article
- Shiga toxin-producing Escherichia coli-associated hemolytic uremic syndrome with recurrent acute cholecystitis: a case report.CEN case reports · 2024Article
- A novel Shiga toxin 2a neutralizing antibody therapeutic with low immunogenicity and high efficacy.Antimicrobial agents and chemotherapy · 2024Article
- Haemolytic uraemic syndrome in children England, Wales, Northern Ireland, and Ireland: A prospective cohort study.Epidemiology and infection · 2023Article
- Shiga toxin-producing Escherichia coli O157:H7 among diarrheic patients and their cattle in Amhara National Regional State, Ethiopia.PloS one · 2023Article
- Microbial Profile of Fresh and Semicooked Nile Tilapia (International journal of microbiology · 2023Article
- Diagnosis and Treatment for Shiga Toxin-ProducingToxins · 2022Review
- Outbreak of STEC O157:H7 linked to a milk pasteurisation failure at a dairy farm in England, 2019.Epidemiology and infection · 2022Article
- The epidemiology of Shiga toxin-producingEpidemiology and infection · 2022Article
- Genomic characterization of multidrug-resistance geneFrontiers in microbiology · 2022Article
- Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAssess the disease severity of Shiga toxin-producing Escherichia coli (STEC) O157 infection and factors influencing the development of typical haemolytic uraemic syndrome (tHUS).
designA retrospective cohort study using data collected through routine surveillance questionnaires between 2009 and 2012.
participants3323 symptomatic cases of STEC O157.
main outcome measuresIncidence of human STEC O157 and tHUS, proportion of cases reporting bloody diarrhoea, hospitalisation, tHUS and death. Odds of progression to tHUS and predicted percentage chance of developing tHUS based on case demographics, STEC O157 strain characteristics and clinical symptoms.
resultsFrom 2009 to 2012, 3323 cases of symptomatic STEC O157 with completed questionnaires were reported, of which 172 developed tHUS (5.18%). Being aged 1-4 years (OR 8.65, 95% CI 5.01 to 14.94, p=0.004) or female (OR 1.61, 95% CI 1.12 to 2.30, p=0.009), being infected with phage type (PT) 21/28 (OR 2.07, 95% CI 1.25 to 3.42, p=0.005) or PT 2 (OR 2.18, 95% CI 1.06 to 4.50, p=0.034), receiving β-lactam antibiotics (OR 4.08, 95% CI 1.43 to 11.68, p=0.009) and presenting with vomiting (OR 3.16, 95% CI 2.16 to 4.62, p<0.001) or bloody diarrhoea (OR 2.10, 95% CI 1.38 to 3.20, p=0.001) were found to be significant risk factors for progression to tHUS. The predicted percentage chance of developing tHUS varied from under 1% to 50% if all risk factors were present.
conclusionsThe data from this study indicate the use of β-lactam antibiotics should be avoided in suspected cases of STEC infection in all age groups, particularly in those under the age of 5.
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