Abstract
To compare neutralizing antibody titres against verotoxin (vt)-1 and vt-2 between children with uncomplicated hemorrhagic colitis (hc) and those with classic hemolytic uremic syndrome (hus). vt antibody titres were also compared in children with hc who received trimethoprim-sulfamethoxazole with those who did not. Prospective study. Tertiary pediatric hospital. Children with hc (n=41) or classic hus (n=12). Serum antibodies against vt-1 and vt-2 were determined by quantitative neutralization. Antibodies were detected in 40% (21 of 53) of serum samples for vt-1 and in 100% (53 of 53) of samples for vt-2. A positive immune response, defined as a fourfold increase in vt antibody titres or as a single titre of 1/64 or greater, was found in 0% (0 of 12) of patients with hus compared with 7% (three of 41) of those with hc for vt-1 (P=0.4); and in 17% (two of 12) of patients with hus compared with 22% (nine of 41) of those with hc for vt-2 (P=0.3). The rate of seroconversion against either vt-1 or vt-2 was comparable in treated and untreated patients with uncomplicated hc. There was no evidence that neutralizing antibody levels against vt-1 or vt-2 in classic hus or after antibiotic therapy are substantially different from those in patients with uncomplicated hc.
Highlights
We considered as positive any serum titre of 1/64 or greater because Karmali et al [3] showed the median convalescent serum titre to be 1/64 among 16 patients with hemolytic uremic syndrome (HUS) with seroconversion against VTEC
Time intervals of serum sample collection from patients with HUS and from those with hemorrhagic colitis (HC) and the time of sample collection after onset of HC were both similar to those reported by others [3,11]
Chart et al [21], using ELISA, failed to differentiate between single serum specimens from patients with HUS and samples from apparently healthy controls; they suggested that antibodies to VT-1 and VT-2 are of little value in the serodiagnosis of HUS caused by E coli O157:H7 [21]
Summary
Immune response to verotoxin 1 and 2 in children with Escherichia coli O157:H7 hemorrhagic colitis and classic hemolytic uremic syndrome. FRANÇOIS PROULX MD, JEAN P TURGEON MD FRCPC, GILLES DELAGE MD MSc FRCPC, HERMY LIOR MSc, LUCETTE LAFLEUR MD FRCPC, LUC CHICOINE MD FRCPC. F PROULX, JP TURGEON, G DELAGE, H LIOR, L LAFLEUR, L CHICOINE.
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