Observational studyPediatric nephrology (Berlin, Germany)2020
Is Shigatoxin 1 protective for the development of Shigatoxin 2-related hemolytic uremic syndrome in children? Data from the ItalKid-HUS Network.
Observational study in Pediatric nephrology (Berlin, Germany), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 23 citations in OpenAlex.
- Pediatric Hemolytic Uremic Syndrome in North-Eastern Germany During the STEC O45:H2 Outbreak in 2025: Clinical Features and Short-Term Outcomes.Open forum infectious diseases · 2026Article
- Recombinant Human Fab Antibodies Differentially Neutralize Shiga Toxin in Renal Epithelial and Endothelial Cells.Toxins · 2026Article
- Inter-society consensus on the management of acute bloody diarrhea and shiga toxin-producing Escherichia coli infection in the molecular microbiology era.Italian journal of pediatrics · 2026Review
- Bloody diarrhea, STEC infection, and HUS in the molecular microbiology era.Pediatric nephrology (Berlin, Germany) · 2026Review
- Diagnostic oriented discrimination of different Shiga toxins via PCA-assisted SERS-based plasmonic metasurface.Nanophotonics (Berlin, Germany) · 2025Article
- INM004: Polyclonal Neutralizing Antibodies Against Shiga Toxin as a Treatment for Hemolytic Uremic Syndrome.Toxins · 2025Review
- Vacation in Egypt associated with Shiga toxin-producingEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2024Article
- Gastrointestinal involvement in STEC-associated hemolytic uremic syndrome: 10 years in a pediatric center.Pediatric nephrology (Berlin, Germany) · 2024Observational
- Thrombotic microangiopathy in children.Pediatric nephrology (Berlin, Germany) · 2022Review
- Characterization of Atypical Shiga Toxin Gene Sequences and Description of Stx2j, a New Subtype.Journal of clinical microbiology · 2022Article
- Hemoglobinuria for the early identification of STEC-HUS in high-risk children: data from the ItalKid-HUS Network.European journal of pediatrics · 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
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShigatoxin (Stx)-producing Escherichia coli (STEC) are the most common causes of hemolytic uremic syndrome (STEC-HUS). The aim of our study is to compare the risk of developing STEC-HUS in relation to the type of Stx genes (Stx1, Stx2, or both).
methodsThis is a prospective, observational, multicenter study involving 63 pediatric units in Northern Italy (ItalKid-HUS Network). STEC-infected children were identified within a screening program for bloody diarrhea during a 10-year period (2010-2019). Stx genes were detected by reverse dot blot or real-time PCR. After the identification of STEC infection, children were followed until diarrhea complete recovery for the possible development of STEC-HUS.
resultsOf the 214 Stx-positive patients, 34 (15.9%) developed STEC-HUS. The risk of HUS in STEC-infected children with Stx1 (n: 62; 29.0%) and Stx2 (n: 97; 45.3%) was respectively 0% and 23.7%, while in patients carrying both Stx1 and Stx2 (n: 55; 25.7%), the risk was 12.7% (p: 0.001).
conclusionsOur data confirm that Stx1 is a very rare cause of STEC-HUS and demonstrate that the risk of STEC-HUS halves in the case of Stx1+2-producing Escherichia coli infection compared with infections where Stx2 is present alone. This observation is helpful in assessing the risk of individual STEC-infected patients for the development of HUS and suggests that Stx1, in the presence of Stx2, might exert a protective role possibly by receptor competition.
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