The central Scotland Escherichia coli O157:H7 outbreak:: Risk factors for the hemolytic uremic syndrome and death among hospitalized patients
The central Scotland Escherichia coli O157:H7 outbreak:: Risk factors for the hemolytic uremic syndrome and death among hospitalized patients
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DOI：
10.1086/322598
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发表时间：
2001-10-01
影响因子：
11.8
通讯作者：
Hutchinson, SJ
中科院分区：
文献类型：
--
作者：
Dundas, S;Todd, WTA;Hutchinson, SJ
关于成人大肠杆菌 O157:H7 感染并发症的危险因素知之甚少。 1996 年苏格兰中部爆发的溶血性尿毒症综合征 (HUS) 成人病例数量最多，最终导致与大肠杆菌 O157:H7 感染相关的死亡人数也是迄今为止最多的。我们对本次疫情中所有住院病例进行回顾性研究，调查了 HUS 的危险因素。 120 例患者中，34 例患有 HUS，其中 28 例为成人。十六名成年人死亡。 HUS 的显着危险因素是年龄 65 岁（比值比 [OR]，4.4；95% 置信区间 [CI]，1.3-14.4）、胃酸过少（OR，6.7；95% CI，1.9-24.0）和同时使用抗生素（OR，4.7；95% CI 1.4-16.5）。与HUS相关的因素如下：白细胞计数> 20 X 10(9)细胞/L（OR，8.25；95% CI，1.1-60.3），中性粒细胞计数> 15 X 10(9)细胞/L（OR，8.5；95% CI，1.5-50.1），以及65岁血清白蛋白水平。早期识别 HUS 危险因素至关重要，可以选择病例患者进行预防和治疗试验。
Little is known about risk factors for complications of Escherichia coli O157:H7 infection in adults. The 1996 outbreak in central Scotland involved the largest number of adult case patients in whom hemolytic uremic syndrome (HUS) developed and, ultimately, the largest number of deaths associated with E coli O157:H7 infection that has yet been recorded. We investigated risk factors for HUS in a retrospective study of all hospitalized case patients in this outbreak. Of 120 case patients, 34 had HUS develop, 28 of whom were adults. Sixteen adults died. Significant risk factors for HUS were age 65 years (odds ratio [OR], 4.4; 95% confidence interval [CI], 1.3-14.4), hypochlorhydria (OR, 6.7; 95% CI, 1.9-24.0), and coincidental antibiotics (OR, 4.7; 95% CI 1.4-16.5). Factors associated with HUS were as follows: white blood cell count > 20 X 10(9) cells/L (OR, 8.25; 95% CI, 1.1-60.3), neutrophil count > 15 X 10(9) cells/L (OR, 8.5; 95% CI, 1.5-50.1), and serum albumin level 65 years of age. Early identification of risk factors for HUS is vital and could select case patients for trials of preventive and treatment therapies.