Emerging Infectious Diseases (May 2004)

Virulence Factors for Hemolytic Uremic Syndrome, Denmark

  • Steen Ethelberg,
  • Katharina E. P. Olsen,
  • Flemming Scheutz,
  • Charlotte Jensen,
  • Peter Schiellerup,
  • Jørgen Engberg,
  • Andreas Munk Petersen,
  • Bente Olesen,
  • Peter Gerner-Smidt,
  • Kåre Mølbak

DOI
https://doi.org/10.3201/eid1005.030576
Journal volume & issue
Vol. 10, no. 5
pp. 842 – 847

Abstract

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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 O group, the combined presence of the eae and stx2 genes is an important predictor of HUS.

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