ESPN 54th Annual Meeting

ESPN 2022


 
Prevalence of shigatoxin producing E. coli in household contacts of children with hemolytic and uremic syndrome
THERESA KWON 1 FLORIAN MANCA BARAYRE 1 CLAIRE DOSSIER 1 VERONIQUE BAUDOUIN 1 AURELIE COINTE 2 STEPHANE BONACORSI 2 PATRICIA MARIANI 2 JULIEN HOGAN 1

1- PEDIATRIC NEPHROLOGY - ROBERT DEBRé HOSPITAL - APHP, PARIS FRANCE
2- MICROBIOLOGY - CENTRE NATIONAL DE RéFéRENCE ESCHERICHIA COLI - ROBERT DEBRé HOSPITAL - APHP, PARIS FRANCE
 
Introduction:

Typical hemolytic uremic syndrome (HUS) is the main cause of acute kidney injury in children under 5 years and occurs after ingestion of Shigatoxin (Stx) producing Escherichia coli (STEC). Prevalence of STEC carriage is unknown in household contacts in France, and has been scarcely studied in other countries.

Objectives: To assess the prevalence of STEC carriage around HUS cases and study the characteristics associated with STEC carriage in the household. 

Material and methods:

Stool samples from patients with diarrhea-associated HUS that presented to our institution between 2007 to 2020. Stool samples were analyzed by Stx RT-PCR (Stx-PCR) to establish the frequency in HUS patients and their contacts.

Results:

179 household contacts of 151 HUS patients were analyzed. The prevalence of Stx detection by PCR in household HUS contacts was 22.9%. 40% of HUS patients had a least one STEC positive household contact. The prevalence was higher in siblings (34.3%), especially in those with little age-difference (<5 years) with the HUS case (37.8%). Thus, age difference < 5 years (versus > 5 years of age difference) and siblings (versus parents) were statistically associated with an increased risk of STEC detection in household contacts. Contacts with diarrhea or with positive Stx-PCR were prescribed azithromycin for 3 days. None of the 179 household contacts developed HUS symptoms.

Conclusions:

Prevalence of STEC carriage in HUS household contacts is higher than in the general population. This population need to be further studied to assess potential protective factors. Further studies are needed to assess whether azithromycin may prevent the development of HUS in household contacts.