[Hemorrhagic colitis and hemolytic-uremic syndrome--E. coli as etiological agent. II. Clinical aspects and epidemiology]

In the last few years a group of verotoxinogenic E. coli bacteria has been defined as a causative agent of hemorrhagic colitis and haemolytic uremic syndrome. The corresponding toxins (verotoxins, Shiga-like-toxins) released from these bacteria play a key role in the pathogenesis and are responsible for the severity of the respective illness. Therefore, besides the clinical and other paraclinical investigations the detection of SLT-producing E. coli or of the corresponding toxins directly in the stool as early as possible has to be included into strategies for diagnostics and therapy. Moreover, it is necessary to avoid the release of huge amounts of toxins (e.g. by antibiotic therapy) and to take care for suitable measures to neutralize or eliminate the toxins. First isolations of enterohaemorrhagic E. coli (EHEC, VTEC) in stool samples from patients suffering from diarrhoeal diseases and HUS in the vicinity of Wernigerode demonstrate the necessity for further bacteriological and epidemiological investigations in order to evaluate frequency and importance of these EHEC bacteria in the pediatric praxis.