Hemolytic-uremic syndrome in children. A serious hazard of undercooked beef

Outbreak of Escherichia coli O157:H7 associated with raw milk consumption in the Pacific Northwest

In late 2005, health officials in Clark County, Washington noted a higher than expected number of Escherichia coli cases among residents and sought to identify a possible common source for infection. In order to identify risk factors, health officials conducted a retrospective cohort study and an environmental site investigation using pulsed-field gel electrophoresis (PFGE) to identify and prevent future cases from occurring. Several lines of evidence supported raw milk as the cause of infections: 1) all ill persons drank raw milk from the same cow share; 2) illness was associated with an increasing amount of milk consumed; 3) E. coli O157:H7 was isolated from raw milk samples and environmental samples collected from the floor of the milking parlour; and 4) PFGE patterns were indistinguishable between case-patients, raw milk samples, and environmental samples. Together, these findings made clear the health risks associated with the consumption of raw milk. The high amount of media interest in this investigation empowered public health officials to work with state legislators to pass State Senate Bill 6377 in Washington State which clarified that state licensing requirements apply to all milk production facilities including cow-share programs.

Effect of antibiotics, levofloxacin and fosfomycin, on a mouse model with Escherichia coli O157 infection

There have been some reservations about the treatment of enterohemorrhagic Escherichia coli (EHEC) infection with antibiotics to prevent the occurrence of hemolytic uremic syndrome (HUS). However, the administration of antimicrobial agents for EHEC infection is under discussion. Therefore, we used an experimental mouse model to assess the advantage/disadvantage of two major antibiotics, levofloxacin (LVFX) and fosfomycin (FOM). Germ-free IQI mice were inoculated with EHEC O157 strain EDL931 or #7. Bacteria colonized feces at 10(9)-10(10) CFU/g, and Shiga toxins (STXs) were detected in the feces. From 1 day after infection, mice were assigned to LVFX (20 mg/kg) once daily or FOM (400 mg/kg) once daily. A significant decrease in overall mortality was observed after treatment of LVFX, with EHEC disappearing immediately from the feces of mice. FOM also reduced mortality for one strain, the STX level decreased gradually. LVFX exhibited higher therapeutic efficacy than FOM. Strain differences were observed in the model during the treatment.

Antibiotic susceptibility of enterohemorrhagic Escherichia coli O157:H7 isolated from an outbreak in Japan in 1996

The antibiotic susceptibilities of 43 strains of Escherichia coli O157:H7 identified in the summer of 1996 in Japan were investigated. Growth of 90% of O157 strains was inhibited at a concentration of < or = 0.5 micro/ml by several agents including fosfomycin with glucose-6-phosphate.

Hemolytic uremic syndrome: just another case of gastroenteritis?

Hemolytic uremic syndrome (HUS), the most common cause of acute renal failure in childhood, has the potential to progress to a life-threatening illness. Its incidence in North America is increasing. Several studies have shown that Escherichia coli O157:H7 is associated with HUS. Although this pathogen was first recognized more than 10 years ago and is relatively common, many physicians are not aware of this diagnosis let alone the spectrum of illness associated with the bacteria. This case exemplifies what appears initially as gastroenteritis but, ultimately, becomes the final diagnosis of HUS. A case is presented to provide additional education to ensure the E coli O157:H7 infection is considered in the differential diagnosis of persons who present with bloody diarrhea.

Hemolytic-uremic syndrome

HUS is one of the most common causes of acute renal failure in childhood. D+ HUS is the most common form and usually follows an episode of hemorrhagic colitis due to VTEC or S. dysenteriae type 1. The SLT elaborated by these organisms is responsible for the endothelial damage that is the initial insult in the pathogenesis of the acute renal failure. Excellent supportive care is necessary to reduce the mortality and morbidity due to HUS.