Faculty Opinions recommendation of Validation of treatment strategies for enterohaemorrhagic Escherichia coli O104:H4 induced haemolytic uraemic syndrome: case-control study.

We report an ongoing, protracted and geographically dispersed outbreak of haemolytic uraemic syndrome (HUS) and gastroenteritis in Germany, involving 30 cases since December 2016. The outbreak was caused by the sorbitol-fermenting immotile variant of Shiga toxin-producing (STEC) Escherichia coli O157. Molecular typing revealed close relatedness between isolates from 14 cases. One HUS patient died. Results of a case–control study suggest packaged minced meat as the most likely food vehicle. Food safety investigations are ongoing.

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Web survey-based selection of controls for epidemiological analyses of a multi-prefectural outbreak of enterohaemorrhagic Escherichia coli O157 in Japan associated with consumption of self-grilled beef hanging tender

Epidemiology and Infection ◽

10.1017/s0950268817003132 ◽

2018 ◽

Vol 146 (4) ◽

pp. 450-457 ◽

Cited By ~ 1

Author(s):

Y. Yahata ◽

N. Ohshima ◽

F. Odaira ◽

N. Nakamura ◽

H. Ichikawa ◽

...

Keyword(s):

Escherichia Coli ◽

Case Control Study ◽

Case Control ◽

Case Definition ◽

Case Control Studies ◽

Local Public Health ◽

Internet Surveys ◽

Enterohaemorrhagic Escherichia Coli ◽

Trace Back ◽

Control Study

AbstractAn outbreak of enterohaemorrhagic Escherichia coli O157 occurred in multiple prefectures of Japan in November 2009. We conducted two case–control studies with trace-back and trace-forward investigations to determine the source. The case definition was met by 21 individuals; 14 (66.7%) were hospitalised, but no haemolytic uraemic syndrome, acute encephalopathy or deaths occurred. Median age was 23 (range 12–48) years and 14 cases were male (66.7%). No significant associations with food were found in a case–control study by local public health centres, but our matched case–control study using Internet surveys found that beef hanging tender (or hanger steak), derived from the diaphragm of the cattle, was significantly associated with illness (odds ratio = 15.77; 95% confidence interval, 2.00–124.11). Pulsed-field gel electrophoresis analysis of isolates from patients and the suspected food showed five different patterns: two in faecal and food samples, and another three in patient faecal samples only, although there were epidemiological links to the meat consumed at the restaurants. Trace-back investigation implicated a common food processing company from outside Japan. Examination of the logistics of the meat processing company suggested that contamination did not occur in Japan. We concluded that the source of the outbreak was imported hanging tender. This investigation revealed that Internet surveys could be useful for outbreak investigations.

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Community-wide outbreak of haemolytic uraemic syndrome associated with Shiga toxin 2-producing Escherichia coli O26:H11 in southern Italy, summer 2013

Eurosurveillance ◽

10.2807/1560-7917.es.2016.21.38.30343 ◽

2016 ◽

Vol 21 (38) ◽

Cited By ~ 28

Author(s):

Cinzia Germinario ◽

Alfredo Caprioli ◽

Mario Giordano ◽

Maria Chironna ◽

Maria Serena Gallone ◽

...

Keyword(s):

Escherichia Coli ◽

Shiga Toxin ◽

Haemolytic Uraemic Syndrome ◽

Case Control Study ◽

Public Health Problem ◽

Case Control ◽

Bulk Milk ◽

Shiga Toxin 2 ◽

Local Plants ◽

Control Study

In summer 2013, an excess of paediatric cases of haemolytic uraemic syndrome (HUS) in a southern region of Italy prompted the investigation of a community-wide outbreak of Shiga toxin 2-producing Escherichia coli (STEC) O26:H11 infections. Case finding was based on testing patients with HUS or bloody diarrhoea for STEC infection by microbiological and serological methods. A case–control study was conducted to identify the source of the outbreak. STEC O26 infection was identified in 20 children (median age 17 months) with HUS, two of whom reported severe neurological sequelae. No cases in adults were detected. Molecular typing showed that two distinct STEC O26:H11 strains were involved. The case–control study showed an association between STEC O26 infection and consumption of dairy products from two local plants, but not with specific ready-to-eat products. E.coli O26:H11 strains lacking the stx genes were isolated from bulk milk and curd samples, but their PFGE profiles did not match those of the outbreak isolates. This outbreak supports the view that infections with Stx2-producing E. coli O26 in children have a high probability of progressing to HUS and represent an emerging public health problem in Europe.

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Risk factors for Escherichia coli bacteraemia: a population-based case-control study

The Lancet ◽

10.1016/s0140-6736(17)33020-9 ◽

2017 ◽

Vol 390 ◽

pp. S85 ◽

Cited By ~ 2

Author(s):

Jiao Song ◽

Angharad Walters ◽

Damon Berridge ◽

Ashley Akbari ◽

Meirion Evans ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Control Study

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Risk factors and outcomes of carbapenem-nonsusceptible Escherichia coli bacteremia: A matched case–control study

Journal of Microbiology Immunology and Infection ◽

10.1016/j.jmii.2010.06.001 ◽

2011 ◽

Vol 44 (2) ◽

pp. 125-130 ◽

Cited By ~ 45

Author(s):

Hong-Jyun Chang ◽

Po-Chang Hsu ◽

Chien-Chang Yang ◽

An-Jing Kuo ◽

Ju-Hsin Chia ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Case Control Study ◽

Case Control ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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717. Antibiotic treatment of Shiga toxin-producing Escherichia coli related gastroenteritis and the risk of hemolytic uremic syndrome: a population based matched case-control study in Japan

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.909 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S409-S410

Author(s):

Shota Myojin ◽

Kyongsun Pak ◽

Mayumi Sako ◽

Tohru Kobayashi ◽

Takuri Takahashi ◽

...

Keyword(s):

Escherichia Coli ◽

Shiga Toxin ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Population Based ◽

Case Control ◽

Age Group ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

Abstract Background The role of therapeutic intervention, particularly antibiotics, for Shiga toxin-producing Escherichia coli (STEC) related infection is controversial. Methods We performed a population based matched case-control study to assess the association between treatment (antibiotics, antidiarrheal agents and probiotics) for STEC related infections and HUS development. We identified all STEC HUS patients as cases and matched five non-HUS patients as controls using the data from the National Epidemiological Surveillance of Infectious Diseases (NESID) between January 1, 2017, and December 31, 2018. Further medical information was obtained by standardized questionnaires answered by physicians who registered each patient. We used multivariate conditional logistic regression model to evaluate the association between exposures (use of antibiotics, use of antidiarrheal agents, days between disease onset and fosfomycin administration [within two or three days]) and the development of HUS, by matched odds ratios (OR) and 95% confidence intervals (CI). Covariates we used were sex, age group, area code, presence of diarrhea and other factors. We also performed subgroup analyses using age (adults and children) as a stratification factor. Results 7,760 STEC related patients were registered in the NESID. We selected patients who had a record of HUS diagnosis (n=182) and matched controls without HUS (n=910). After collecting standardized paper-based questionnaires, we enrolled 90 HUS patients and 371 non-HUS patients for analysis. In the main analysis, matched OR of fosfomycin was 0.75(0.47-1.20) in all ages, 1.41(0.51-3.88) in adults and 0.58(0.34-1.01) in children. Matched OR of antidiarrheal agents was 2.07(1.07-4.03) in all ages, 1.84(0.32-10.53) in adults, 2.65(1.21-5.82) in children. Matched OR of probiotics was 0.86(0.46-1.61) in all ages, 0.76(0.21-2.71) in adults, 1.00(0.48-2.09) in children. There was no significant association between the timing of fosfomycin use in the first two or five days of illness and HUS development in any age group. Conclusion Our results suggest that fosfomycin might decrease the risk of HUS in children younger than 15 years of age with STEC confirmed bacterial gastroenteritis. Disclosures All Authors: No reported disclosures

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Bacteremia Caused by Escherichia coli producing Extended-spectrum Beta-lactamase: a Case-control Study of Risk Factors and Outcomes

Scandinavian Journal of Infectious Diseases ◽

10.1080/00365540210147516 ◽

2002 ◽

Vol 34 (8) ◽

pp. 567-573 ◽

Cited By ~ 76

Author(s):

Pak-Leung Ho ◽

Wai-Ming Chan ◽

Samson S. Y. Wong ◽

Karl Young ◽

Kenneth W. T. Tsang

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Case Control Study ◽

Case Control ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Control Study

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Escherichia coli O157:H7 outbreak linked to salami, British Columbia, Canada, 1999

Epidemiology and Infection ◽

10.1017/s0950268803001651 ◽

2004 ◽

Vol 132 (2) ◽

pp. 283-289 ◽

Cited By ~ 55

Author(s):

D. M. MacDONALD ◽

M. FYFE ◽

A. PACCAGNELLA ◽

A. TRINIDAD ◽

K. LOUIE ◽

...

Keyword(s):

Escherichia Coli ◽

Case Control Study ◽

Meat Products ◽

Case Control ◽

Pfge Pattern ◽

Escherichia Coli O157 ◽

E Coli ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

An outbreak of E. coli O157:H7 infections was identified in November 1999 with a fivefold increase in the occurrence of laboratory-confirmed cases of E. coli O157:H7 infection. A matched case-control study was conducted. Samples of food from cases and from retailers were analysed for the presence of E. coli O157:H7. A total of 143 cases were identified over a 12-week period with the same pulsed-field gel electrophoresis (PFGE) pattern. The case-control study found that Company A salami was significantly associated with illness (Mantel–Haenszel matched odds ratio 10·0, 95% CI 1·4–434, P=0·01). Company A salami tested positive for E. coli O157:H7 and isolates had the same PFGE pattern as case isolates. An immediate voluntary national recall of Company A dry fermented meat products took place. Findings from the investigation of this outbreak suggest that the hold-and-test option may not be adequate to prevent shiga-toxigenic Escherichia coli (STEC) infection in salami consumers.

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