Virulence factors for hemolytic uremic syndrome, Denmark.

Emerging Infectious Diseases

PubMedID: 15200817

Ethelberg S, Olsen KE, Scheutz F, Jensen C, Schiellerup P, Enberg J, Petersen AM, Olesen B, Gerner-Smidt P, Mølbak K. Virulence factors for hemolytic uremic syndrome, Denmark. Emerging Infect Dis. 2004;10(5):842-7.
We present an analysis of strain and patient factors associated with the development of bloody diarrhea and hemolytic uremic syndrome (HUS) among Shiga toxin-producing Escherichia coli (STEC) patients registered in Denmark in a 6-year period. Of 343 STEC patients, bloody diarrhea developed in 36.4% and HUS in 6.1%. In a multivariate logistic regression model, risk factors for bloody diarrhea were the eae and stx2 genes, O groups O157 and O103, and increasing age. Risk factors for HUS were presence of the stx2 (odds ratio [OR] 18.9) and eae (OR undefined) genes, being a child, and having bloody diarrhea. O group O157, although associated with HUS in a univariate analysis (OR 4.0), was not associated in the multivariate analysis (OR 1.1). This finding indicates that, rather than the O group, the combined presence of the eae and stx2 genes is an important predictor of HUS.