Importance of case age in the purported association between phylogenetics and hemolytic uremic syndrome in Escherichia coli O157:H7 infections.
Epidemiol Infect
; 146(12): 1550-1555, 2018 09.
Article
en En
| MEDLINE
| ID: mdl-29914582
ABSTRACT
Escherichia coli O157H7 is the largest cause of hemolytic uremic syndrome (HUS). Previous studies proposed that HUS risk varies across the E. coli O157H7 phylogenetic tree (hypervirulent clade 8), but the role of age in the association is unknown. We determined phylogenetic lineage of E. coli O157H7 isolates from 1160 culture-confirmed E. coli O157H7 cases reported in Washington State, 2004-2015. Using generalised estimating equations, we tested the association between phylogenetic lineage and HUS. Age was evaluated as an effect modifier. Among 1082 E. coli O157H7 cases with both phylogenetic lineage and HUS status (HUS n = 76), stratified analysis suggested effect modification by age. Lineages IIa and IIb, relative to Ib, did not appear associated with HUS in children 0-9-years-old. For cases 10-59-years-old, lineages IIa and IIb appeared to confer increased risk of HUS, relative to lineage Ib. The association reversed in ⩾60-year-olds. Results were similar for clade 8. Phylogenetic lineage appears to be associated with HUS risk only among those ⩾10-years-old. Among children <10, the age group most frequently affected, lineage does not explain progression to HUS. However, lineage frequency varied across age groups, suggesting differences in exposure and/or early disease manifestation.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Escherichia coli O157
/
Infecciones por Escherichia coli
/
Síndrome Hemolítico-Urémico
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Child
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Child, preschool
/
Female
/
Humans
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Infant
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Male
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Middle aged
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Epidemiol Infect
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
EPIDEMIOLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Canadá