Association between uremic hemolytic syndrome and infection by Shiga toxin-producing Escherichia coli

Between January 1997 and December 2002, a total of 208 pediatric patients with hemolytic uremic syndrome (HUS) were studied to establish its association with Shiga toxin-producing Escherichia coli (STEC) infection. The median age was 22 +/- 19 months, and 53.8% were female patients. Cases were mainly well nourished children (85.1%) from a middle class condition (52%); 95.5% had diarrhea, (bloody diarrhea in 74.2%), during the summer and at the beginning of autumn (75%). Forty-four per cent received antibiotic therapy during the prodromic period. STEC was isolated in 9.8% of the cases, being Escherichia coli O157:H7 the most frequent serotype isolated (83.3%). Shiga free toxin was detected in stools (StxMF) in 21% of the samples studied. Cumulative evidences of infection by STEC were found in 59.1% of the patients.