Is Shigatoxin 1 protective for the development of Shigatoxin 2-related hemolytic uremic syndrome in children? Data from the ItalKid-HUS Network

Autor: Dario Consonni, Giovanni Montini, Maurizio Brigotti, Laura Daprai, Ilaria Possenti, Chiara Vignati, Mario Luini, Valentina Capone, Gianluigi Ardissino
Přispěvatelé: Ardissino G., Possenti I., Vignati C., Daprai L., Capone V., Brigotti M., Luini M.V., Consonni D., Montini G.
Rok vydání: 2020
Předmět:
Nephrology
Diarrhea
medicine.medical_specialty
030232 urology & nephrology
030204 cardiovascular system & hematology
medicine.disease_cause
urologic and male genital diseases
Shiga Toxin 1
Gastroenterology
Risk Assessment
Shiga Toxin 2
03 medical and health sciences
0302 clinical medicine
fluids and secretions
STX2
Internal medicine
hemic and lymphatic diseases
medicine
Hemolytic uremic syndrome
Humans
In patient
Prospective Studies
Child
Escherichia coli
Children
Escherichia coli infection
Escherichia coli Infections
biology
Shiga-Toxigenic Escherichia coli
business.industry
Infant
Shiga toxin
Protective Factors
bacterial infections and mycoses
Molecular Typing
Child
Preschool
Pediatrics
Perinatology and Child Health
Hemolytic-Uremic Syndrome
biology.protein
bacteria
Bloody diarrhea
Female
medicine.symptom
business
Zdroj: Pediatric nephrology (Berlin, Germany). 35(10)
ISSN: 1432-198X
Popis: Background: Shigatoxin (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). Methods: This 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. Results: Of 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). Conclusions: Our 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.
Databáze: OpenAIRE
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