VEROCYTOTOXIN-PRODUCING ESCHERICHIA-COLI INFECTION IN HEMOLYTIC-UREMIC SYNDROME IN PART OF WESTERN-EUROPE

From September 1989 until September 1993, stool specimens and sera fro m 113 children with diarrhoea-associated haemolytic uraemic syndrome ( HUS) from the Netherlands, two university hospitals in Belgium and one university hospital in Germany were examined for the presence of vero cytotoxin-producing Escherichia coli (VTEC) infection. Evidence for VT EC infection was observed in 88 (78%) patients with HUS compared to 2 (3%) of the 65 children with acute gastro-enteritis Serotype O157 was the causative agent in 76 (86%) of these 88 patients with VTEC-associa ted HUS and verocytotoxin-2 (VT-2) was the most frequent toxin produce d. Serological testing for antibodies to O157 O-antigen yielded the hi ghest number of positive results compared to the other test methods. A ntibodies to O157 were found in sera of 71 (65%) of 110 patients with HUS and one control serum. Stool and sera examination for VTEC in 95 f amily contacts of 28 patients with HUS demonstrated an evidence for VT EC infection 33 (35%). In contrast, in patients with HUS serological a ntibodies to O157 O-antigen were found in only 3 (4%) of 85 family con tacts. Conclusion In this part of Western Europe, VT2-producing Escher ichia coli, mainly those belonging to serogroup O157, are the major ca use of HUS in childhood.