Full Citation

Title: Importance of case age in the purported association between phylogenetics and hemolytic uremic syndrome in Escherichia coli O157:H7 infections

Citation Type: Journal Article

Publication Year: 2018

ISBN:

ISSN: 14694409

DOI: 10.1017/S0950268818001632

NSFID:

PMCID:

PMID: 29914582

Abstract: Escherichia coli O157:H7 is the largest cause of hemolytic uremic syndrome (HUS). Previous studies proposed that HUS risk varies across the E. coli O157:H7 phylogenetic tree (hypervirulent clade 8), but the role of age in the association is unknown. We determined phylogenetic lineage of E. coli O157:H7 isolates from 1160 culture-confirmed E. coli O157:H7 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 O157:H7 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.

Url: https://pubmed.ncbi.nlm.nih.gov/29914582/

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Authors: Tarr, Gillian A.M.; Shringi, S.; Oltean, H. N.; Mayer, J.; Rabinowitz, Peter; Wakefield, Jon; Tarr, Phillip I.; Besser, Thomas E.; Phipps, Amanda I.

Periodical (Full): Epidemiology and Infection

Issue: 12

Volume: 146

Pages: 1550-1555

Countries: