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Hemolytic uremic syndrome in pediatric intensive care units in são paulo, Brazil

Renato Lopes de Souza1, João Tomás Abreu Carvalhaes, Lucilia Sanae Nishimura

  • 1Pediatric Intensive Care Unit, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil.

The Open Microbiology Journal
|August 2, 2011
PubMed

Insights

Shiga toxin-producing Escherichia coli (STEC) causes hemolytic uremic syndrome (HUS) in children, leading to acute renal failure. This study highlights the prevalence of STEC O157 in São Paulo HUS cases, emphasizing the need for early diagnosis and treatment.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Microbiology

Background:

  • Hemolytic uremic syndrome (HUS) is a leading cause of acute renal failure in children.
  • Shiga toxin-producing Escherichia coli (STEC) is a primary pathogen responsible for post-diarrheal HUS.
  • Understanding STEC serotypes and their clinical impact is crucial for pediatric care.

Purpose of the Study:

  • To investigate the clinical and microbiological features of 13 pediatric HUS cases in São Paulo, Brazil.
  • To identify STEC strains and associated serological markers in HUS patients.
  • To highlight the role of specific STEC serotypes, particularly O157, in HUS etiology.

Main Methods:

  • Collected epidemiologic, clinical, and laboratory data from HUS patients.
  • Analyzed fecal samples for STEC isolation and identified genetic sequences of Shiga toxin (Stx).
  • Assessed serum samples for antibodies against lipopolysaccharide (LPS) O26, O111, and O157.

Main Results:

  • STEC was identified in 3 patients (serotypes O26:H11, O157:H7, O165:H-).
  • Elevated IgM against LPS O111 (n=2) and O157 (n=7) was detected in 9 patients.
  • Combined methods confirmed STEC infection in 92.3% of cases; O157 STEC was notably prevalent.

Conclusions:

  • Combined microbiologic and serologic methods effectively diagnose STEC-associated HUS.
  • Shiga toxin-producing E. coli O157 is a significant, previously underestimated cause of HUS in São Paulo.
  • Early identification and management of STEC infections are vital in pediatric acute renal failure cases.

Keywords:
E. coli O157Hemolytic Uremic SyndromeShiga toxinchildren.dialysisdiarrheapediatric intensive care unit

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