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Antibiotic treatment of Escherichia coli O157 infection and the risk of hemolytic uremic syndrome, Minnesota.
Pediatr Infect Dis J. 2012 Jan; 31(1):37-41.PI

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.

Authors+Show Affiliations

Acute Disease Investigation and Control Section, Minnesota Department of Health, St Paul, MN 55164, USA. kirk.smith@state.mn.usNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

21892124

Citation

Smith, Kirk E., et al. "Antibiotic Treatment of Escherichia Coli O157 Infection and the Risk of Hemolytic Uremic Syndrome, Minnesota." The Pediatric Infectious Disease Journal, vol. 31, no. 1, 2012, pp. 37-41.
Smith KE, Wilker PR, Reiter PL, et al. Antibiotic treatment of Escherichia coli O157 infection and the risk of hemolytic uremic syndrome, Minnesota. Pediatr Infect Dis J. 2012;31(1):37-41.
Smith, K. E., Wilker, P. R., Reiter, P. L., Hedican, E. B., Bender, J. B., & Hedberg, C. W. (2012). Antibiotic treatment of Escherichia coli O157 infection and the risk of hemolytic uremic syndrome, Minnesota. The Pediatric Infectious Disease Journal, 31(1), 37-41. https://doi.org/10.1097/INF.0b013e31823096a8
Smith KE, et al. Antibiotic Treatment of Escherichia Coli O157 Infection and the Risk of Hemolytic Uremic Syndrome, Minnesota. Pediatr Infect Dis J. 2012;31(1):37-41. PubMed PMID: 21892124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antibiotic treatment of Escherichia coli O157 infection and the risk of hemolytic uremic syndrome, Minnesota. AU - Smith,Kirk E, AU - Wilker,Peter R, AU - Reiter,Paul L, AU - Hedican,Erin B, AU - Bender,Jeff B, AU - Hedberg,Craig W, PY - 2011/9/6/entrez PY - 2011/9/6/pubmed PY - 2012/5/4/medline SP - 37 EP - 41 JF - The Pediatric infectious disease journal JO - Pediatr. Infect. Dis. J. VL - 31 IS - 1 N2 - 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. SN - 1532-0987 UR - https://www.unboundmedicine.com/medline/citation/21892124/Antibiotic_treatment_of_Escherichia_coli_O157_infection_and_the_risk_of_hemolytic_uremic_syndrome_Minnesota_ L2 - http://dx.doi.org/10.1097/INF.0b013e31823096a8 DB - PRIME DP - Unbound Medicine ER -