Shiga Toxin-Producing E. coli and Hemolytic Uremic Syndrome: A Study of the 2022 Outbreak in Turkey

BACKGROUND Shiga toxin-producing Escherichia coli (STEC) causes serious bacterial illnesses from consuming undercooked meat and foods contaminated with feces. This study aimed to describe the characteristics of an STEC outbreak associated with hemolytic uremic syndrome (HUS) that emerged in Turkey and affected 21 adults. MATERIAL AND METHODS The medical records of 21 adult patients who were admitted to Ankara Bilkent City Hospital Internal Medicine Intensive Care Department with the diagnosis of HUS between July and September 2022 were retrospectively evaluated through the system. RESULTS While a positive correlation was detected between the length of hospital stay and N-terminus pro-B-type natriuretic peptide (NT-proBNP), lactate dehydrogenase (LDH), and troponin during hospitalization, a negative correlation was detected with glomerular filtration rate (GFR). Patients requiring plasmapheresis had higher creatinine, amylase, and LDH values at the time of admission. In patients given eculizumab, high NT-proBNP and creatinine levels and low GFR levels at the time of admission were found to be statistically significant. The use of antibiotics before admission did not change the length of hospital stay. CONCLUSIONS A statistically significant difference was detected between LDH, GFR, troponin, NT-proBNP parameters, and length of hospital stay. Creatine and LDH values of patients requiring eculizumab and plasmapheresis at the time of admission were found to be statistically high. It should be kept in mind that eculizumab and plasmapheresis treatment can be required for patients with elevated creatine and LDH at the time of admission.