ArticleEpidemiology and infection2016
Estimating true incidence of O157 and non-O157 Shiga toxin-producing Escherichia coli illness in Germany based on notification data of haemolytic uraemic syndrome.
Article in Epidemiology and infection, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 42 citations in OpenAlex.
- Genomic epidemiology reveals statewide dispersal of clinical Shiga toxin-producingMicrobiology spectrum · 2026Article
- Pathogenic Factors and Recent Study on the Rapid Detection of Shiga Toxin-Producing Escherichia coli (STEC).Molecular biotechnology · 2025Review
- Prevalence, virulence factors, and antimicrobial resistance profiles of Shiga toxin-producingVeterinary research forum : an international quarterly journal · 2023Article
- 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.Microbiology spectrum · 2022Article
- Review
- Genomic Insights Into Clinical Shiga Toxin-ProducingFrontiers in microbiology · 2021Article
- Article
- Do changes in STEC diagnostics mislead interpretation of disease surveillance data in Switzerland? Time trends in positivity, 2007 to 2016.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2020Article
- Epidemiology of Shiga Toxin-ProducingInternational journal of environmental research and public health · 2020Article
- The importance of integrating genetic strain information for managing cases of Shiga toxin-producingEpidemiology and infection · 2019Article
- Development and Validation of Shiga Toxin-ProducingMicroorganisms · 2019Article
- Implementation of multiplex PCR diagnostics for gastrointestinal pathogens linked to increase of notified Shiga toxin-producing Escherichia coli cases in Norway, 2007-2017.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Article
- Article
- Article
- [Infectious diseases and their ICD coding : What could be improved by the introduction of ICD-11?]Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2018Review
- Gastroenteritis in an adult female revealing hemolytic uremic syndrome: Case report.World journal of gastroenterology · 2018Article
- Short- and Long-Term Renal Outcome of Hemolytic-Uremic Syndrome in Childhood.Frontiers in pediatrics · 2018Article
- Haemolytic uremic syndrome surveillance in children less than 15 years in Belgium, 2009-2015.Archives of public health = Archives belges de sante publique · 2018Article
- Twenty-seven years of screening for Shiga toxin-producing Escherichia coli in a university hospital. Brussels, Belgium, 1987-2014.PloS one · 2018Article
- Multiplex real-time PCR assay for detection of Escherichia coli O157:H7 and screening for non-O157 Shiga toxin-producing E. coli.BMC microbiology · 2017Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Shiga toxin-producing Escherichia coli (STEC) is an important cause of gastroenteritis (GE) and haemolytic uraemic syndrome (HUS). Incidence of STEC illness is largely underestimated in notification data, particularly of serogroups other than O157 ('non-O157'). Using HUS national notification data (2008-2012, excluding 2011), we modelled true annual incidence of STEC illness in Germany separately for O157 and non-O157 STEC, taking into account the groups' different probabilities of causing bloody diarrhoea and HUS, and the resulting difference in their under-ascertainment. Uncertainty of input parameters was evaluated by stochastic Monte Carlo simulations. Median annual incidence (per 100 000 population) of STEC-associated HUS and STEC-GE was estimated at 0·11 [95% credible interval (CrI) 0·08-0·20], and 35 (95% CrI 12-145), respectively. German notification data underestimated STEC-associated HUS and STEC-GE incidences by factors of 1·8 and 32·3, respectively. Non-O157 STEC accounted for 81% of all STEC-GE, 51% of all bloody STEC-GE and 32% of all STEC-associated HUS cases. Non-O157 serogroups dominate incidence of STEC-GE and contribute significantly to STEC-associated HUS in Germany. This might apply to many other countries considering European surveillance data on HUS. Non-O157 STEC should be considered in parallel with STEC O157 when searching aetiology in patients with GE or HUS, and accounted for in modern surveillance systems.
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