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Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives

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  • Authors: T. Keefe Davis1, Nicole C. A. J. Van De Kar2, Phillip I. Tarr3
  • Editors: Vanessa Sperandio4, Carolyn J. Hovde5
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Division of Nephrology, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110; 2: Division of Nephrology, Department of Pediatrics, Radboud University Medical Centre, Nijmegen, The Netherlands; 3: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, and Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO 63110; 4: University of Texas Southwestern Medical Center, Dallas, TX; 5: University of Idaho, Moscow, ID
    • Source: microbiolspec August 2014 vol. 2 no. 4 doi:10.1128/microbiolspec.EHEC-0025-2014
  • Received 08 January 2014 Accepted 22 January 2014 Published 15 August 2014
  • Phillip I. Tarr, [email protected]
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  • Abstract:

    strains that produce Shiga toxins/verotoxins are rare, but important, causes of human disease. They are responsible for a spectrum of illnesses that range from the asymptomatic to the life-threatening hemolytic-uremic syndrome; diseases caused by belonging to serotype O157:H7 are exceptionally severe. Each illness has a fairly predictable trajectory, and good clinical practice at one phase can be inappropriate at other phases. Early recognition, rapid and definitive microbiology, and strategic selection of tests increase the likelihood of good outcomes. The best management of these infections consists of avoiding antibiotics, antimotility agents, and narcotics and implementing aggressive intravenous volume expansion, especially in the early phases of illness.

  • Citation: Davis T, Van De Kar N, Tarr P. 2014. Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives. Microbiol Spectrum 2(4):EHEC-0025-2014. doi:10.1128/microbiolspec.EHEC-0025-2014.

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/content/journal/microbiolspec/10.1128/microbiolspec.EHEC-0025-2014
2014-08-15
2019-10-19

Abstract:

strains that produce Shiga toxins/verotoxins are rare, but important, causes of human disease. They are responsible for a spectrum of illnesses that range from the asymptomatic to the life-threatening hemolytic-uremic syndrome; diseases caused by belonging to serotype O157:H7 are exceptionally severe. Each illness has a fairly predictable trajectory, and good clinical practice at one phase can be inappropriate at other phases. Early recognition, rapid and definitive microbiology, and strategic selection of tests increase the likelihood of good outcomes. The best management of these infections consists of avoiding antibiotics, antimotility agents, and narcotics and implementing aggressive intravenous volume expansion, especially in the early phases of illness.

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Shiga Toxin/Verocytotoxin-Producing Infections: Practical Clinical Perspectives
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Citation: Davis T, Van De Kar N, Tarr P. 2014. Shiga toxin/verocytotoxin-producing infections: practical clinical perspectives. microbiolspec 2(4): doi:10.1128/microbiolspec.EHEC-0025-2014
/content/microbiolspec/10.1128/microbiolspec.EHEC-0025-2014.T1
TABLE 1

Acuity pyramid. Frequency of recovery of O157:H7 and non-O157:H7 STEC/VTEC, according to the setting of acquisition of specimen

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TABLE 1

Acuity pyramid. Frequency of recovery of O157:H7 and non-O157:H7 STEC/VTEC, according to the setting of acquisition of specimen

Source: microbiolspec August 2014 vol. 2 no. 4 doi:10.1128/microbiolspec.EHEC-0025-2014
/content/microbiolspec/10.1128/microbiolspec.EHEC-0025-2014.T2
TABLE 2

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

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TABLE 2

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

Source: microbiolspec August 2014 vol. 2 no. 4 doi:10.1128/microbiolspec.EHEC-0025-2014
/content/microbiolspec/10.1128/microbiolspec.EHEC-0025-2014.T3
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

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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

Source: microbiolspec August 2014 vol. 2 no. 4 doi:10.1128/microbiolspec.EHEC-0025-2014
/content/microbiolspec/10.1128/microbiolspec.EHEC-0025-2014.T4
TABLE 4

Selected nonnephrologic, nonhematologic complications of HUS

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TABLE 4

Selected nonnephrologic, nonhematologic complications of HUS

Source: microbiolspec August 2014 vol. 2 no. 4 doi:10.1128/microbiolspec.EHEC-0025-2014

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