TY - JOUR
T1 - Shiga-toxin-producing Escherichia coli and haemolytic uraemic syndrome
AU - Tarr, Phillip I.
AU - Gordon, Carrie A.
AU - Chandler, Wayne L.
N1 - Funding Information:
We thank Sandra Watkins, Han-Mou Tsai, and J Evan Sadler for critical reading of the review and helpful suggestions, Helge Karch for stimulating discussions, Jennifer Bradley and James Dowd for assistance in preparation of the review, Christine A Musser for artwork, and patient, families, laboratory workers, housestaff, and physicians for assistance in our studies. The work of PIT and WLC has been supported by National Institutes of Diabetes and Digestive and Kidney Diseases grant RO1 DK52081. These funding agencies had no role in the preparation of this seminar.
PY - 2005/3/19
Y1 - 2005/3/19
N2 - Most cases of diarrhoea-associated haemolytic uraemic syndrome (HUS) are caused by Shiga-toxin-producing bacteria; the pathophysiology differs from that of thrombotic thrombocytopenic purpura. Among Shiga-toxin-producing Escherichia coli (STEC), O157:H7 has the strongest association worldwide with HUS. Many different vehicles, in addition to the commonly suspected ground (minced) beef, can transmit this pathogen to people. Antibiotics, antimotility agents, narcotics, and non-steroidal anti-inflammatory drugs should not be given to acutely infected patients, and we advise hospital admission and administration of intravenous fluids. Management of HUS remains supportive; there are no specific therapies to ameliorate the course. The vascular injury leading to HUS is likely to be well under way by the time infected patients seek medical attention for diarrhoea. The best way to prevent HUS is to prevent primary infection with Shiga-toxin-producing bacteria.
AB - Most cases of diarrhoea-associated haemolytic uraemic syndrome (HUS) are caused by Shiga-toxin-producing bacteria; the pathophysiology differs from that of thrombotic thrombocytopenic purpura. Among Shiga-toxin-producing Escherichia coli (STEC), O157:H7 has the strongest association worldwide with HUS. Many different vehicles, in addition to the commonly suspected ground (minced) beef, can transmit this pathogen to people. Antibiotics, antimotility agents, narcotics, and non-steroidal anti-inflammatory drugs should not be given to acutely infected patients, and we advise hospital admission and administration of intravenous fluids. Management of HUS remains supportive; there are no specific therapies to ameliorate the course. The vascular injury leading to HUS is likely to be well under way by the time infected patients seek medical attention for diarrhoea. The best way to prevent HUS is to prevent primary infection with Shiga-toxin-producing bacteria.
UR - https://www.scopus.com/pages/publications/15244348050
U2 - 10.1016/S0140-6736(05)71144-2
DO - 10.1016/S0140-6736(05)71144-2
M3 - Article
C2 - 15781103
AN - SCOPUS:15244348050
SN - 0140-6736
VL - 365
SP - 1073
EP - 1086
JO - Lancet
JF - Lancet
IS - 9464
ER -