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Related Experiment Video

Updated: May 24, 2025

A High-throughput Platform for the Screening of Salmonella spp./Shigella spp.

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Predicting Progression of STEC-HUS: Use of Shiga Toxin Subtype and Routine Laboratory Screening.

Lydia Maleknia¹, Zahra Samiezade-Yazd², Xing Luu¹

¹Department of Pediatrics, Kaiser Permanente Northern California, Oakland, CA, United States.

Journal of the Pediatric Infectious Diseases Society

|March 4, 2025

Summary

Shiga toxin-producing E. coli (STEC) can cause hemolytic uremic syndrome (HUS). Children under 5 with specific STEC toxin profiles, particularly Shiga toxin 2 (stx2), face the highest HUS risk.

Keywords:

Escherichia coli Shiga toxin hemolytic uremic syndrome screening guidelines stool

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Published on: April 9, 2018

Area of Science:

Pediatric Infectious Diseases
Microbiology
Nephrology

Background:

Hemolytic uremic syndrome (HUS) is a severe complication of Shiga toxin-producing Escherichia coli (STEC) infections.
Accurate identification of STEC toxin profiles and clinical factors predicting HUS is crucial for guiding management and screening protocols.

Purpose of the Study:

To determine specific Shiga toxin-producing E. coli (STEC) toxin profiles and clinical variables associated with the highest risk of developing hemolytic uremic syndrome (HUS).
To inform the development of evidence-based screening guidelines for HUS in children.

Main Methods:

A 5-year retrospective study analyzed data from 1071 children under 18 with STEC-positive stool.
Demographics, clinical symptoms, and laboratory results were collected, and logistic regression identified predictors of HUS progression.

Main Results:

Fifty-five children developed HUS, with higher risk observed in those under 5 years and infected with E. coli O157 or non-O157 strains producing Shiga toxin 2 (stx2).
No HUS cases occurred in children with O157 alone, O157 and stx1, or non-O157 stx1 and stx2. Vomiting, dehydration, and abnormal blood counts/chemistry were clinical predictors.

Conclusions:

HUS risk is significantly influenced by E. coli serotype and Shiga toxin (stx) type, with stx2 being a primary driver.
Screening guidelines should consider E. coli serotype and stx results. Families need counseling on HUS symptoms and dehydration prevention; serial lab monitoring is for high-risk children.