SHIGA-LIKE TOXIN-PRODUCING ESCHERICHIA-COLI O111 AND ASSOCIATED HEMOLYTIC-UREMIC SYNDROME - A FAMILY OUTBREAK

Objective. To describe a family cluster of Shiga toxin-producing Esche richia coli O111ac:NM infection. Study design. The index case was iden tified as part of a United States prospective study of hemolytic-uremi c syndrome. Epidemiologic investigation was conducted through intervie ws. E. coli O111:NM infection was characterized through culture and se rology. Shiga toxin 1 and 2 gene sequences were determined with oligon ucleotide DNA probes. Results. All three children and both parents had nonbloody diarrhea, vomiting and abdominal cramps, and one child deve loped hemolytic-uremic syndrome. Shiga toxin 1- and 2-producing E. col i O111ac:NM was isolated from two children. IgG antibodies to E. coli O111 were detected in all three children. Conclusions. To our knowledg e this is the first reported cluster of O111 infection and only the se cond caused by non-O157 Shiga toxin-producing E. coli in North America .