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Escherichia coli productor de Shiga-toxina y el síndrome urémico hemolítico
Phillip I Tarr1, Carrie A Gordon, Wayne L Chandler
1Division of Gastroenterology, Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, Campus Box 8208, 660 South Euclid Avenue, St Louis, MO 63110, USA. tarr@wustl.edu
Lancet (London, England)
|March 23, 2005
Resumen
La prevención de las infecciones bacterianas que producen Shiga-toxina es la mejor estrategia para evitar el síndrome urémico hemolítico (HUS). El manejo actual para HUS es de apoyo, ya que las terapias específicas no están disponibles, y la intervención temprana es crucial.
Área de la Ciencia:
- Microbiología Microbiología.
- Enfermedades infecciosas Enfermedades infecciosas.
- Nefrología Nefrología.
Sus antecedentes:
- El síndrome urémico hemolítico asociado a la diarrea (HUS) es causado principalmente por bacterias productoras de Shiga-toxina.
- El Escherichia coli (STEC) O157: H7 productor de Shiga-toxina es una de las principales causas mundiales de HUS.
- La fisiopatología del HUS difiere de la púrpura trombótica trombocitopénica.
Objetivo del estudio:
- Para resumir la comprensión de la fisiopatología, la transmisión y el manejo de HUS.
- Para resaltar la importancia de prevenir las infecciones bacterianas primarias.
Principales métodos:
- Revisión de la literatura y síntesis de los conocimientos actuales sobre HUS.
- Análisis de STEC O157:H7 como agente etiológico primario.
- Discusión de los cuidados de apoyo y contraindicaciones en el manejo de HUS.
Principales resultados:
- Varios vehículos, no sólo la carne molida, pueden transmitir STEC.
- Ciertos medicamentos (antibióticos, agentes antimotilidad, narcóticos, AINE) están contraindicados en la infección aguda.
- Se recomienda la atención de apoyo, incluidos los fluidos intravenosos y la hospitalización.
- La lesión vascular en HUS a menudo comienza antes de que se busque atención médica.
Conclusiones:
- No existen terapias específicas para alterar el curso de HUS.
- La prevención de las infecciones bacterianas que producen la toxina Shiga es la medida preventiva más efectiva.
- La atención médica temprana y la atención de apoyo son fundamentales para el manejo de los pacientes con HUS.
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