Abstract
The mean annual incidence of hemolytic uremic syndrome in persons <15 years of age in Italy from 1988 to 2000 was 0.28 per 100,000 population. Laboratory investigations showed that Shiga toxin–producing Escherichia coli (STEC) infection occurred in 73.1% of patients. STEC O157 was the most common serotype, but a considerable number of cases were from infections by non-O157 STEC.
Highlights
Hemolytic uremic syndrome (HUS) is the most severe and specific clinical manifestation of infections with Shiga toxin (Stx)–producing Escherichia coli (STEC), especially E. coli O157:H7 and other enterohemorrhagic serotypes; the incidence of HUS represents a robust index of the total incidence of these infections in a population [1]
The very low incidence observed in most regions of southern Italy and in the islands suggests that the Mediterranean basin is an area with a low incidence of Shiga toxin–producing Escherichia coli (STEC) infection [10,11]
These findings suggest that person-to-person transmission may play a major role in the epidemiology of sporadic HUS cases, as described in other studies [5,12]
Summary
The incidence observed in this study is the lowest among those reported in Europe for the same period [5,6,7,8,9,10] This finding, together with the rare occurrence of outbreaks [3,4], suggests that STEC infections are relatively uncommon in Italy. Serotyping of isolated STEC strains and detection of serogroup-specific LPS antibodies showed evidence of infection with STEC O157 in 74 patients. >50% of STEC-positive cases had evidence of infection with non-O157 STEC This proportion is higher than that reported in studies conducted in the United States [14], France [7], United Kingdom [6], Belgium [8], and the Netherlands [15] and suggests that the circulation of STEC O157 in Italy is lower than in other countries. Our findings underscore the potential for person-to-person transmission of STEC infection
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