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2013-11-14Zeitschriftenartikel DOI: 10.1371/journal.pone.0078180
Shiga Toxin-Producing Escherichia coli O157 Is More Likely to Lead to Hospitalization and Death than Non-O157 Serogroups – Except O104
dc.contributor.authorPreußel, Karina
dc.contributor.authorHöhle, Michael
dc.contributor.authorStark, Klaus
dc.contributor.authorWerber, Dirk
dc.date.accessioned2018-05-07T17:13:15Z
dc.date.available2018-05-07T17:13:15Z
dc.date.created2013-11-15
dc.date.issued2013-11-14none
dc.identifier.otherhttp://edoc.rki.de/oa/articles/rehYmxOvPExLg/PDF/22r1fltkeY2Fw.pdf
dc.identifier.urihttp://edoc.rki.de/176904/1730
dc.description.abstractThe clinical spectrum following infection with Shiga toxin-producing Escherichia coli (STEC) is wide ranging and includes hemorrhagic colitis and life-threatening hemolytic uremic syndrome (HUS). Severity of STEC illness depends on patients' age and strongly on the infecting strains' virulence. Serogroup O157 is often assumed to be more virulent than others. Age-adjusted population-based data supporting this view are lacking thus far. We conducted a large retrospective cohort study among patients of community-acquired gastroenteritis or HUS diagnosed with STEC infection, reported in Germany January 2004 through December 2011. Age-adjusted risks for reported hospitalization and death, as proxies for disease severity, were estimated for STEC serogroups separately, and compared with STEC O157 (reference group) using Poisson regression models with robust error estimation. A total of 8,400 case-patients were included in the analysis; for 2,454 (29%) and 30 (0.4%) hospitalization and death was reported, respectively. Highest risks for hospitalization, adjusted for age and region of residence, were estimated for STEC O104 (68%; risk ratio [RR], 1.33; 95% confidence interval [CI], 1.19–1.45), followed by STEC O157 (46%). Hospitalization risks for the most prevalent non-O157 serogroups (O26, O103, O91, O145, O128, O111) were consistently and markedly lower than for O157, with the highest RR for O145 (0.54; 95% CI, 0.41–0.70) and the lowest for O103 (0.27; 95% CI, 0.20–0.35). Mortality risk of O104 was similar to O157 (1.2% each), but the group of all other non-O157 STEC had only 1/10 the risk (RR, 0.09; 95% CI, 0.02–0.32) compared to O157. The study provides population-based and age-adjusted evidence for the exceptional high virulence of STEC O157 in relation to non-O157 STEC other than O104. Timely diagnosis and surveillance of STEC infections should prioritize HUS-associated E. coli, of which STEC O157 is the most important serogroup.eng
dc.language.isoeng
dc.publisherRobert Koch-Institut, Infektionsepidemiologie
dc.subjectHumanseng
dc.subjectFemaleeng
dc.subjectMaleeng
dc.subjectAdolescenteng
dc.subjectAdulteng
dc.subjectAgedeng
dc.subjectGermany/epidemiologyeng
dc.subjectMiddle Agedeng
dc.subjectRisk Factorseng
dc.subjectPrevalenceeng
dc.subjectSpecies Specificityeng
dc.subjectChild Preschooleng
dc.subjectInfanteng
dc.subjectChildeng
dc.subjectRetrospective Studieseng
dc.subjectHospitalizationeng
dc.subjectHemolytic-Uremic Syndrome/microbiologyeng
dc.subjectEscherichia coli O157/pathogenicityeng
dc.subjectHemolytic-Uremic Syndrome/mortalityeng
dc.subject.ddc610 Medizin
dc.titleShiga Toxin-Producing Escherichia coli O157 Is More Likely to Lead to Hospitalization and Death than Non-O157 Serogroups – Except O104
dc.typeperiodicalPart
dc.identifier.urnurn:nbn:de:0257-10033721
dc.identifier.doi10.1371/journal.pone.0078180
dc.identifier.doihttp://dx.doi.org/10.25646/1655
local.edoc.container-titlePLoS ONE
local.edoc.container-textPreußel K, Höhle M, Stark K, Werber D (2013) Shiga Toxin-Producing Escherichia coli O157 Is More Likely to Lead to Hospitalization and Death than Non-O157 Serogroups – Except O104. PLoS ONE 8(11): e78180.
local.edoc.fp-subtypeArtikel
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttp://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0078180
local.edoc.container-publisher-namePublic Library of Science
local.edoc.container-volume8
local.edoc.container-issue11
local.edoc.container-year2013

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