Journal Article

The Central Scotland <i>Escherichia coli</i> O157:H7 Outbreak: Risk Factors for the Hemolytic Uremic Syndrome and Death among Hospitalized Patients

Stephanie Dundas, W. T. Andrew Todd, Alastair I. Stewart, Peter S. Murdoch, A. K. R. Chaudhuri and Sharon J. Hutchinson

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 7, pages 923-931
Published in print October 2001 | ISSN: 1058-4838
Published online October 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/322598
The Central Scotland Escherichia coli O157:H7 Outbreak: Risk Factors for the Hemolytic Uremic Syndrome and Death among Hospitalized Patients

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Little is known about risk factors for complications of Escherichia coli O157:H7 infection in adults. The 1996 outbreak in central Scotland involved the largest number of adult case patients in whom hemolytic uremic syndrome (HUS) developed and, ultimately, the largest number of deaths associated with E. coli O157:H7 infection that has yet been recorded. We investigated risk factors for HUS in a retrospective study of all hospitalized case patients in this outbreak. Of 120 case patients, 34 had HUS develop, 28 of whom were adults. Sixteen adults died. Significant risk factors for HUS were age <15 years or >65 years (odds ratio [OR], 4.4; 95% confidence interval [CI], 1.3–14.4), hypochlorhydria (OR, 6.7; 95% CI, 1.9–24.0), and coincidental antibiotics (OR, 4.7; 95% CI 1.4–16.5). Factors associated with HUS were as follows: white blood cell count > 20 × 109 cells/L (OR, 8.25; 95% CI, 1.1–60.3), neutrophil count > 15 × 109 cells/L (OR, 8.5; 95% CI, 1.5–50.1), and serum albumin level <35 g/L (OR, 7.2; 95% CI, 1.2–42.5) ≥3 days after symptom onset. Deaths were confined to case patients >65 years of age. Early identification of risk factors for HUS is vital and could select case patients for trials of preventative and treatment therapies.

Journal Article.  3836 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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