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Chapter 15 : Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives

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Abstract:

Shiga toxin (Stx)-producing (STEC) cause illness with a spectrum of severity ranging from mild (even asymptomatic) carriage to life-threatening disease ( ). STEC infections are relatively uncommon; in the United States, extrapolation of data from FoodNet ( ) to a nationwide population that exceeds 300,000,000 indicates there are fewer than 4,000 diagnosed cases of O157:H7 infection per annum. O157:H7 remains the near-exclusive cause of hemolytic-uremic syndrome (HUS) throughout most of the world, and the single serotype on which most data have been generated. Therefore, we emphasize this particular pathogen in this article. The European Food Safety Authority and the European Centre for Disease Prevention and Control report similar epidemiology: 4,000 confirmed infections caused by Stx-producing strains (mostly belonging to the O157 serogroup) in 27 European Union member states. The number of reported infections attributed to strains that produce Shiga toxins has increased since 2008 ( ).

Citation: Davis T, van De Kar N, Tarr P. 2015. Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives, p 321-339. In Sperandio V, Hovde C (ed), Enterohemorrhagic and Other Shiga Toxin-Producing . ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EHEC-0025-2014

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Tables

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TABLE 1

Acuity pyramid

Citation: Davis T, van De Kar N, Tarr P. 2015. Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives, p 321-339. In Sperandio V, Hovde C (ed), Enterohemorrhagic and Other Shiga Toxin-Producing . ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EHEC-0025-2014
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TABLE 2

Summary of antibiotic experience in multiple case control studies of children and adults

Citation: Davis T, van De Kar N, Tarr P. 2015. Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives, p 321-339. In Sperandio V, Hovde C (ed), Enterohemorrhagic and Other Shiga Toxin-Producing . ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EHEC-0025-2014
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TABLE 3

Severity of HUS in series identified in PubMed published between 2009 and 2013, using search terms hemolytic-uremic syndrome AND children, on September 4, 2013

Citation: Davis T, van De Kar N, Tarr P. 2015. Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives, p 321-339. In Sperandio V, Hovde C (ed), Enterohemorrhagic and Other Shiga Toxin-Producing . ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EHEC-0025-2014
Generic image for table
TABLE 4

Selected nonnephrologic, nonhematologic complications of HUS

Citation: Davis T, van De Kar N, Tarr P. 2015. Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives, p 321-339. In Sperandio V, Hovde C (ed), Enterohemorrhagic and Other Shiga Toxin-Producing . ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EHEC-0025-2014