Epidemiology and Infection



Haemolytic uraemic syndrome and Shiga toxin-producing Escherichia coli infection in children in France


B. DECLUDT a1c1, P. BOUVET a2, P. MARIANI-KURKDJIAN a3, F. GRIMONT a2, P. A. D. GRIMONT a2, B. HUBERT a1, C. LOIRAT a4 and THE SOCIÉTÉ DE NÉPHROLOGIE PÉDIATRIQUE  1
a1 Réseau National de Santé Publique, Saint-Maurice, France
a2 Unité des Entérobactéries, Institut Pasteur, Paris, France
a3 Laboratoire de Microbiologie, Hôpital Robert Debré, Paris, France
a4 Service de Néphrologie, Hôpital Robert Debré, Paris, France

Abstract

We conducted a study to determine the incidence of haemolytic uraemic syndrome (HUS) in children in France and to assess the role of Shiga-toxin-producing Escherichia coli (STEC) infection in the aetiology of HUS. In collaboration with the Société de Néphrologie Pédiatrique we undertook a retrospective review of all cases of HUS hospitalized from January 1993 to March 1995 and a 1-year prospective study (April 1995–March 1996) of epidemiological and microbiological features of cases of HUS. The polymerase chain reaction (PCR) procedure was used to detect stx, eae, e-hlyA genes directly from case stool samples. Serum samples from cases were examined for antibodies to lipopolysaccharide (LPS) of 26 major STEC serogroups. Two hundred and eighty-six cases were reported. The average incidence per year was 0·7/105 children < 15 years and 1·8/105 children < 5 years. During the prospective study, 122/130 cases were examined for evidence of STEC infection using PCR and/or serological assays and 105 (86%) had evidence of STEC infection. Serum antibodies to E. coli O157 LPS were detected in 79 (67%) cases tested. In conclusion, this study showed that STEC infection is an important cause of HUS in children in France, with a high proportion related to the O157 serogroup.

(Accepted October 16 1999)


Correspondence:
c1 Author for correspondence.


Footnotes

1 HUS French Study Group Members: B. Boudailliez (Amiens); G. Champion (Angers); P. Richard (Angoulème); C. Wright (Annecy); A. Burguet (Besançon); J. P. Hehunstre (Bordeaux); L. De Parscau (Brest); P. Eckart (Caen); J. B. Palcoux (Clermont- Ferrand); J. B. Gouyou (Dijon); G. Bourdat (Grenoble); J. P. Dommergues (Kremlin Bicêtre); M. Foulard (Lille); M. Guillot (Lisieux); P. Cochat (Lyon); B. Parchoux (Lyon); G. Picon (Marseille); R. Dumas (Montpellier); J. L. André (Nancy); C. Guyot (Nantes); E. Berard (Nice); A. Bensman (Paris); C. Loirat (Paris); M. Broyer (Paris); B. Roussel (Reims); E. Le Gall (Rennes); G. Landthaler (Rouen); M. P. Lavocat (St Etienne); M. Fischbach (Strasbourg); P. Barthe (Toulouse); H. Nivet (Tours).



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