Predictors for the development of haemolytic uraemic syndrome with Escherichia coli O157 : H7 infections: with focus on the day of illness

Citation
K. Ikeda et al., Predictors for the development of haemolytic uraemic syndrome with Escherichia coli O157 : H7 infections: with focus on the day of illness, EPIDEM INFE, 124(3), 2000, pp. 343-349
Citations number
21
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medical Research General Topics
Journal title
EPIDEMIOLOGY AND INFECTION
ISSN journal
0950-2688 → ACNP
Volume
124
Issue
3
Year of publication
2000
Pages
343 - 349
Database
ISI
SICI code
0950-2688(200006)124:3<343:PFTDOH>2.0.ZU;2-U
Abstract
A large outbreak of Escherichia coli O157 infections via school lunches occ urred at primary schools in 1996 in Sakai City, Japan. As many as 10000 pat ients suffered from diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome (HUS). Using data on 288 inpatient school children affected by thi s outbreak, of whom 36 presented complete HUS and the remaining 252 tested positive for E. coli O157 culture, we attempted to identify predictors for the progression to HUS. Within the first 5 days of illness, clinical featur es associated with inpatients who developed I-IUS compared with those witho ut HUS included a C reactive protein (CRP) level higher than 1.2 mg/dl (OR 44.26; 95% CI 5.83-336.23), a white blood cell (WBC) count greater than 11. 0 x 10(9)/l (OR 5.03; 95 % CI 2.13-11.87) and a temperature higher than 38. 0 degrees C (OR 5.00; 95 % CI 2.25-11.08). It can be concluded that these t hree factors are predictive factors for the development of HUS in patients with E. coli O157 infection, and patients who have two or all of these fact ors should be observed closely.