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Cited by 156Escherichia coli research studiesComplement system in diseasesSalmonella and Campylobacter epidemiology

Antibiotic Treatment of Escherichia coli O157 Infection and the Risk of Hemolytic Uremic Syndrome, Minnesota

Smith, Kirk E., Wilker, Peter R., Reiter, Paul L., Hedican, Erin B., Bender, Jeff B., Hedberg, Craig W.·2012·Pediatric Infectious Disease Journal
DOI 10.1097/inf.0b013e31823096a8
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Abstract

BACKGROUND: Infection with Escherichia coli O157 (O157) can lead to the development of hemolytic uremic syndrome (HUS). Treating O157 infections with antibiotics is a possible risk factor for HUS development; however, previous studies evaluating this relationship have yielded conflicting results. The objective of this study was to further evaluate this issue. METHODS: An age-matched case-case comparison study comprising Minnesota residents less than 20 years of age with culture-confirmed O157 infection who did (n = 66) or did not (n = 129) subsequently develop HUS was conducted. Subjects were identified through statewide surveillance activities by the Minnesota Department of Health from 1996 to 2002. RESULTS: Overall antibiotic treatment was not associated with the development of HUS. Self-reported vomiting and female gender were significantly associated with the development of HUS. After adjustment for illness severity and gender, subjects who developed HUS were more likely to have been treated only with bactericidal antibiotics within the first 3 days (adjusted matched odds ratio [OR], 12.4; 95% confidence interval [CI], 1.4-110.3) or within the first 7 days (OR, 18.0; 95% CI, 1.9-170.9) after the onset of diarrhea. In particular, the use of β-lactams (penicillins or cephalosporins) in the first 3 days after diarrhea onset was also significant after adjustment (OR, 11.3; 95% CI, 1.2-106.7). CONCLUSIONS: Individuals infected with O157 infection presenting with a more severe illness were at an increased risk of developing HUS. The use of bactericidal antibiotics, particularly β-lactams, to treat O157 infection was associated with the subsequent development of HUS.

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Authors
Smith, K. E., Wilker, P. R., Reiter, P. L., Hedican, E. B., Bender, J. B., & Hedberg, C. W.
Affiliations
  • Minnesota Department of Health (US)
  • University of Minnesota (US)
Corresponding author
  • Smith, Kirk E.
  • Wilker, Peter R.
  • Reiter, Paul L.
  • Hedican, Erin B.
ORCID
Venue
Pediatric Infectious Disease Journal
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-01
Volume
31
Issue
1
Pages
37-41
ISSN
0891-3668 (ISSN-L)
DOI
10.1097/inf.0b013e31823096a8
OpenAlex
W1996913586
Cited by
156
References
23
Citations by year
2026: 4 · 2025: 14 · 2024: 6 · 2023: 8 · 2022: 10 · 2021: 11 · 2020: 12 · 2019: 10 · 2018: 11 · 2017: 8 · 2016: 10 · 2015: 13 · 2014: 14 · 2013: 14 · 2012: 11
FWCI
7.27
Type
journal article
Language
en
Open access
closed
Locations
  • The Pediatric Infectious Disease Journal (publishedVersion)
  • PubMed (publishedVersion)
Funders
U.S. Public Health Service (U50/CCU511190)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Escherichia coli research studies
  • Life Sciences › Immunology and Microbiology › Immunology › Complement system in diseases
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
Keywords
Escherichia coli O157, hemolytic uremic syndrome, antibiotic therapy, bactericidal antibiotics, beta-lactam antibiotics, penicillin, cephalosporins, Shiga toxin-producing Escherichia coli infection, pediatric infection, disease severity, risk factors
MeSH terms
Adolescent, Anti-Bacterial Agents, Child, Child, Preschool, Escherichia coli Infections, Female, Hemolytic-Uremic Syndrome, Humans, Infant, Infant, Newborn, Male, Minnesota, Risk Factors, Severity of Illness Index, Case-Control Studies, Escherichia coli O157, beta-Lactams, Young Adult

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