| Autor: |
Ylinen, E. (Elisa), Salmenlinna, S. (Saara), Halkilahti, J. (Jani), Jahnukainen, T. (Timo), Korhonen, L. (Linda), Virkkala, T. (Tiia), Rimhanen-Finne, R. (Ruska), Nuutinen, M. (Matti), Kataja, J. (Janne), Arikoski, P. (Pekka), Linkosalo, L. (Laura), Bai, X. (Xiangning), Matussek, A. (Andreas), Jalanko, H. (Hannu), Saxén, H. (Harri) |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
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| Popis: |
Background: Hemolytic uremic syndrome (HUS) is a multisystemic disease. In a nationwide study, we characterized the incidence, clinical course, and prognosis of HUS caused by Shiga toxin (Stx)–producing Escherichia coli (STEC) strains with emphasis on risk factors, disease severity, and long-term outcome. Methods: The data on pediatric HUS patients from 2000 to 2016 were collected from the medical records. STEC isolates from fecal cultures of HUS and non-HUS patients were collected from the same time period and characterized by whole genome sequencing analysis. Results: Fifty-eight out of 262 culture-positive cases developed verified (n = 58, 22%) STEC-HUS. Another 29 cases had probable STEC-HUS, the annual incidence of STEC-HUS being 0.5 per 100,000 children. Eleven different serogroups were detected, O157 being the most common (n = 37, 66%). Age under 3 years (OR 2.4), stx2 (OR 9.7), and stx2a (OR 16.6) were found to be risk factors for HUS. Fifty-five patients (63%) needed dialysis. Twenty-nine patients (33%) developed major neurological symptoms. Complete renal recovery was observed in 57 patients after a median 4.0 years of follow-up. Age under 3 years, leukocyte count over 20 × 10⁹/L, and need for dialysis were predictive factors for poor renal outcome. Conclusions: Age under 3 years, stx2, and stx2a were risk factors for HUS in STEC-positive children. However, serogroup or stx types did not predict the renal outcome or major CNS symptoms. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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