Hemolytic uremic syndrome (HUS) associated with shiga toxin E. coli(STEC) is one of the most common causes of acute kidney injury in young children. The share of STEC-HUS among all HUS variants is up to 90%. Not all STECs are pathogenic to humans, and those that cause disease (hemorrhagic colitis, HUS) are referred to as enterohemorrhagic E. coli(EHEC). The main pathogens causing STEC-HUS include the serotype E. coliO157: H7, less often serotypes O26, O80, O103, O121, O145. EHEC exist as normal microbiota in cattle, but can also be found in goats, sheep, pigs, chickens, dogs, and rats. Infection can occur when using undercooked ground beef, unpasteurized milk, water, including tap water and from open ponds and pools, from an infected person and when visiting farms and zoos. The epidemiological history should be carefully assessed in each patient with HUS, taking into account the annual outbreaks of this disease in different regions of the world. In recent years actively discussed the issue of the transfer of shiga toxin (Stx) from the intestine to the blood and from the blood to target organs in the form of microvesicles, the wall of which is the outer shell of E.coliand blood cells. This allows Stx to escape the response of the human immune system. The article describes in detail the mechanisms of infection and expression of pathogenic genes of EHEC, the effect of Stx on endothelial cells, on expression of adhesion molecules and inflammatory chemokines, activation of the alternative complement pathway, which determine the development of HUS.
P0334HEMOLYTIC UREMIC SYNDROME: CLINICAL PRESENTATION, LABORATORY FINDINGS, MANAGEMENT AND OUTCOMES