ABO and P1 blood group antigen expression and stx genotype and outcome of childhood Escherichia coli O157:H7 infections

P1 and ABO antigens and bacterial stx genotypes might influence the risk of developing hemolytic uremic syndrome (HUS) after Escherichia coli O157:H7 infections. We determined ABO status and P1 antigen expression in 130 infected and 17 uninfected children, and we determined the stx genotype of the infecting isolate. P1 expression was weakly and directly related to HUS risk (P = .04), but this risk did not extend to the group with the greatest P1 expression. P1 expression remained constant as HUS evolved. The ABO frequency was similar in all groups. These associations were not affected by the stx genotype. stx1^-stx2⁺ E. coli O157:H7 strains were more commonly associated with HUS than were stx1⁺stx2⁺ strains (P = .21), and 1 child with HUS was infected with a rare stx1⁺stx2^- isolate. In the present study, ABO antigens and stx genotypes were not major determinants of the outcome of E. coli O157:H7 infections, and P1 expression did not protect against the development of HUS.