, Volume 27, Issue 6, pp 341–347

EnterohemorrhagicEscherichia coli (EHEC) in Pediatric Hemolytic-Uremic Syndrome: A Prospedtive Study in Germany and Austria*


  • H.M. Verweyen
    • Childrens' University Hospital, Mathildenstr. 1, D-79106 Freiburg, Germany, Phone: +49-761-270-4309, Fax: +49-761-270-4407, e-mail:
  • H. Karch
    • Institute for Hygiene and Microbiology, Josef-Schneider-Str. 2, D-9708 Würzburg, Germany, e-mail:
  • F. Allerberger
    • Institute for Hygiene, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria, e-mail:
  • L.B. Zimmerhackl
    • Childrens' University Hospital, Mathildenstr. 1, D-79106 Freiburg, Germany, Phone: +49-761-270-4309, Fax: +49-761-270-4407, e-mail:
Clinical and Epidemiological Studies

DOI: 10.1007/s150100050040

Cite this article as:
Verweyen, H., Karch, H., Allerberger, F. et al. Infection (1999) 27: 341. doi:10.1007/s150100050040


Studies from Europe indicate that infections with enterohemorrhagic Escherichia coli (EHEC) non-O157:H7 strains are increasing in frequency as a cause of hemolytic-uremic syndrome (HUS). In 1997 a prospective study was performed in Germany and Austria to assess the distribution of EHEC serotypes, to characterize the clinical course and to examine environmental aspects. 95 children with a diagnosis of HUS were evaluated in Germany and Austria. Diarrhea, which was bloody in 67%, was reported in 97% of patients. Oligo-/anuria occurred in 76% of patients, of which 63% required dialysis. Two patients showed neurological sequelae at the 2-month follow-up, both of them were infected with non-O157;H7 serotypes. Case fatality in the acute stage was 3/95, in two of these patients EHEC was isolated. Stool and serum specimens were analyzed for the presence of EHEC and antibodies against O157 lipopolysaccharide (LPS). Serotype O157:H7 was identified in 36/58 (62%) isolates, 22 strains (38%) belonged to non-O157:H7. Combining stool culture with serology, EHEC infection was documented in 88% of patients, including three patients without diarrhea. Non-O157:H7 serotypes occurred in 77% of children up to 36 months of age and were the most prevalent serotype in children up to 12 months of age.

Key words Hemolytic-uremic syndromeDiarrheaRenal insufficiencyE. coliEnterohemorrhagicEpidemiologySerology
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© Urban & Vogel Medien und Medizin Verlagsgesellschaft 1999