TY - JOUR
T1 - Hemolytic uremic syndrome and diarrhea in argentine children
T2 - The role of shiga-like toxins
AU - Lopez, Eduardo L.
AU - Diaz, Mario
AU - Grinstein, Saul
AU - Devoto, Susana
AU - Mendilaharzu, Fernando
AU - Murray, Barbara E.
AU - Ashkenazi, Shai
AU - Rubeglio, Etelvina
AU - Woloj, Mabel
AU - Vasquez, Miriam
AU - Turco, Marisa
AU - Pickering, Larry K.
AU - Cleary, Thomas G.
N1 - Funding Information:
Received for publication 30 December 1988and in revised form 24 April 1989. Informed consent was obtained from all parents. This study was approved by the Research Committee at the Hospital de Niiios "Ricardo Gutierrez" in Buenos Aires and by the Committee for the Protection of Human Subjects at the University of TexasMedical School in Houston. This study was supported by a grant from the Thrasher Research Fund. The authors thank Rory Van, Delores Reich, and Melanie Benton for technical assistance and Anne Wright for secretarial assistance. Please address requests for reprints to Dr. Thomas G. Cleary, Department of Pediatrics, University of Texas Medical School at Houston, 6431Fannin Street, Room 1.739,Houston, TX 77030.
PY - 1989/9
Y1 - 1989/9
N2 - Shiga-like toxin-producing Escherichia coli have been associated with hemorrhagic colitis and the hemolytic uremic syndrome (HUS). BecauseArgentina has the highest reported frequency of HUS in the world, Argentine children were prospectively studied during the HUS season for evidence of Shiga-like toxin-related diseases. On the basis of serology, fecal cytotoxin neutralization, stool cultures, and DNA hybridization of colony lysates, most children with HUS had evidence of infection with Shiga-like toxin-producing organisms. Children with spring-summer diarrhea also commonly (320'/0, confidence interval 18%-46%) had clear-cut evidence of such infection. No controls (children without gastrointestinal, renal, or hemolytic disease) had free fecal cytotoxin, positive cultures for E. coli 0157:H7, or DNA probe-positive organisms; 20% of them had low serum titers of antibodies to Shiga-like toxins. E. coli0157:H7 was not common in either HUS or diarrhea patients. The high frequency of Shiga-like toxin-induced diarrhea in young children in Argentina probably explains the high incidence of HUS in this country and suggests that HUS is a relatively uncommon complication of Shiga-like toxin-related disease.
AB - Shiga-like toxin-producing Escherichia coli have been associated with hemorrhagic colitis and the hemolytic uremic syndrome (HUS). BecauseArgentina has the highest reported frequency of HUS in the world, Argentine children were prospectively studied during the HUS season for evidence of Shiga-like toxin-related diseases. On the basis of serology, fecal cytotoxin neutralization, stool cultures, and DNA hybridization of colony lysates, most children with HUS had evidence of infection with Shiga-like toxin-producing organisms. Children with spring-summer diarrhea also commonly (320'/0, confidence interval 18%-46%) had clear-cut evidence of such infection. No controls (children without gastrointestinal, renal, or hemolytic disease) had free fecal cytotoxin, positive cultures for E. coli 0157:H7, or DNA probe-positive organisms; 20% of them had low serum titers of antibodies to Shiga-like toxins. E. coli0157:H7 was not common in either HUS or diarrhea patients. The high frequency of Shiga-like toxin-induced diarrhea in young children in Argentina probably explains the high incidence of HUS in this country and suggests that HUS is a relatively uncommon complication of Shiga-like toxin-related disease.
UR - http://www.scopus.com/inward/record.url?scp=0024400037&partnerID=8YFLogxK
U2 - 10.1093/infdis/160.3.469
DO - 10.1093/infdis/160.3.469
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C2 - 2668430
AN - SCOPUS:0024400037
SN - 0022-1899
VL - 160
SP - 469
EP - 475
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 3
ER -