Hemolytic uremic syndrome associated to shigatoxin producing Escherichia coli in Chilean children: Clinical and epidemiological aspects Síndrome hemolítico urémico asociado a infección intestinal por Escherichia coli productora de shigatoxina (STEC) en pa

Abstract

Clinical and epidemiological aspects of shigatoxin producing E. coli (STEC) infections and hemolytic uremic syndrome (HUS) are reviewed. Surveillance results from 14 sentinel centers during 2000-2002 showed a mean incidence rate of 3.4 HUS cases per 100.000 children, with the highest incidence in the 6 to 28 month age group. Disease is endemic with summer peaks. Between 1988 and 2002 we obtained the clinical characteristics of a group of 119 HUS children with the following results: mean age 16 months, bloody diarrhea 57.8%, no previous diarrhea 9%, 60% received antibiotics, 72% had oligoanuria, 53% required dialysis, 15% had seizures and 31% had dizziness; mortality was 3%. Four foodborne outbreaks have been detected in Santiago, two outbreaks occurred in household settings, one in a Day Care Center and one in a Neonatal Unit. Recommendations for diagnosis, treatment and prevention of STEC infections, including potential vaccines are discussed.