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Importance of case age in the purported association between phylogenetics and hemolytic uremic syndrome in Escherichia coli O157:H7 infections.
Epidemiol Infect. 2018 09; 146(12):1550-1555.EI

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.

Authors+Show Affiliations

Department of Pediatrics,University of Calgary Cumming School of Medicine,Calgary,Alberta,CA.Veterinary Microbiology and Pathology,Washington State University,Pullman,Washington,USA.Washington State Department of Health,Shoreline, Washington,USA.Department of Epidemiology,University of Washington,Seattle,Washington,USA.Department of Environmental and Occupational Health Sciences and Center for One Health Research,University of Washington,Seattle,Washington,USA.Departments of Biostatistics and Statistics,University of Washington,Seattle,Washington,USA.Department of Pediatrics,Washington University in St. Louis School of Medicine,St. Louis,Missouri,USA.Veterinary Microbiology and Pathology,Washington State University,Pullman,Washington,USA.Department of Epidemiology,University of Washington,Seattle,Washington,USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

29914582

Citation

Tarr, G A M., et al. "Importance of Case Age in the Purported Association Between Phylogenetics and Hemolytic Uremic Syndrome in Escherichia Coli O157:H7 Infections." Epidemiology and Infection, vol. 146, no. 12, 2018, pp. 1550-1555.
Tarr GAM, Shringi S, Oltean HN, et al. Importance of case age in the purported association between phylogenetics and hemolytic uremic syndrome in Escherichia coli O157:H7 infections. Epidemiol Infect. 2018;146(12):1550-1555.
Tarr, G. A. M., Shringi, S., Oltean, H. N., Mayer, J., Rabinowitz, P., Wakefield, J., Tarr, P. I., Besser, T. E., & Phipps, A. I. (2018). Importance of case age in the purported association between phylogenetics and hemolytic uremic syndrome in Escherichia coli O157:H7 infections. Epidemiology and Infection, 146(12), 1550-1555. https://doi.org/10.1017/S0950268818001632
Tarr GAM, et al. Importance of Case Age in the Purported Association Between Phylogenetics and Hemolytic Uremic Syndrome in Escherichia Coli O157:H7 Infections. Epidemiol Infect. 2018;146(12):1550-1555. PubMed PMID: 29914582.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Importance of case age in the purported association between phylogenetics and hemolytic uremic syndrome in Escherichia coli O157:H7 infections. AU - Tarr,G A M, AU - Shringi,S, AU - Oltean,H N, AU - Mayer,J, AU - Rabinowitz,P, AU - Wakefield,J, AU - Tarr,P I, AU - Besser,T E, AU - Phipps,A I, Y1 - 2018/06/19/ PY - 2018/6/20/pubmed PY - 2019/4/2/medline PY - 2018/6/20/entrez KW - Epidemiology KW - Escherichia coli (E. coli) KW - Shiga toxin-producing E. coli KW - phylogenetics SP - 1550 EP - 1555 JF - Epidemiology and infection JO - Epidemiol. Infect. VL - 146 IS - 12 N2 - 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. SN - 1469-4409 UR - https://www.unboundmedicine.com/medline/citation/29914582/Importance_of_case_age_in_the_purported_association_between_phylogenetics_and_hemolytic_uremic_syndrome_in_Escherichia_coli_O157:H7_infections_ L2 - https://www.cambridge.org/core/product/identifier/S0950268818001632/type/journal_article DB - PRIME DP - Unbound Medicine ER -