TY - JOUR
T1 - Escherichia coli O157:H7 infections
T2 - Discordance between filterable fecal shiga toxin and disease outcome
AU - Cornick, Nancy A.
AU - Jelacic, Srdjan
AU - Ciol, Marcia A.
AU - Tarr, Phillip I.
N1 - Funding Information:
Financial support: National Institute of Diabetes and Digestive and Kidney Diseases (1RO1DK52081); US Department of Agriculture National Research Initiative Competitive Grants Program (35201-10057) and Specific Cooperative Agreement (58-3625-0-120).
PY - 2002/7/1
Y1 - 2002/7/1
N2 - Shiga toxin (Stx)-producing Escherichia coli O157:H7 are the most common cause of hemolytic uremic syndrome (HUS). We detected free fecal Stx in 48%, 40%, and 17% of infected children with uncomplicated diarrhea, children who subsequently developed HUS, and children with HUS, respectively. Vero cell assay detected Stx more frequently than did a commercial Stx enzyme immunoassay. In children's stool samples obtained on or before day 4 of illness, each 10-fold decrease in titer was, paradoxically, associated with 3.8-fold increased odds of developing HUS (P = .03; 95% confidence interval, 0.77-19.7). The fecal Stx type did not correlate with the Stx expressed by bacteria grown in vitro and was not related to bacterial titer in the studied samples. These data suggest that therapeutic and diagnostic strategies directed toward binding or identifying intraintestinal fecal Stx may have limited success.
AB - Shiga toxin (Stx)-producing Escherichia coli O157:H7 are the most common cause of hemolytic uremic syndrome (HUS). We detected free fecal Stx in 48%, 40%, and 17% of infected children with uncomplicated diarrhea, children who subsequently developed HUS, and children with HUS, respectively. Vero cell assay detected Stx more frequently than did a commercial Stx enzyme immunoassay. In children's stool samples obtained on or before day 4 of illness, each 10-fold decrease in titer was, paradoxically, associated with 3.8-fold increased odds of developing HUS (P = .03; 95% confidence interval, 0.77-19.7). The fecal Stx type did not correlate with the Stx expressed by bacteria grown in vitro and was not related to bacterial titer in the studied samples. These data suggest that therapeutic and diagnostic strategies directed toward binding or identifying intraintestinal fecal Stx may have limited success.
UR - http://www.scopus.com/inward/record.url?scp=0036642517&partnerID=8YFLogxK
U2 - 10.1086/341295
DO - 10.1086/341295
M3 - Article
C2 - 12089662
AN - SCOPUS:0036642517
SN - 0022-1899
VL - 186
SP - 57
EP - 63
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 1
ER -