Albersmeier J P, Bremer J P, Dammermann W, Lüth S, Hagenmüller F, Rüther C, Otto H, Nielsen A M, Schumacher U, Ullrich S
Anatomie und Experimentelle Morphologie, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany.
Abteilung für Rheumatologie und Immunology, Klinikum Bad Bramstedt, Bad Bramstedt, Germany.
PLoS One. 2018 Feb 8;13(2):e0191544. doi: 10.1371/journal.pone.0191544. eCollection 2018.
Shiga-toxin producing O157:H7 Entero Haemorrhagic E. coli [STEC/EHEC] are the most common cause of Haemolytic Uraemic Syndrome [HUS] related to infectious haemorrhagic colitis. Nearly all recommendations on long term treatment of EHEC infections refer to this strain. The 2011 outbreak in Northern Europe was the first of this dimension to be caused by the serotype O104:H4. We report on the 3.5 year follow up of 61 patients diagnosed with symptomatic EHEC O104:H4 infection in spring 2011.
Patients with EHEC O104 infection were followed in a monocentric, prospective observational study at four time points: 4, 12, 24 and 36 months. These data include the patients' histories, clinical findings, and complications.
Sixty-one patients suffering from EHEC O104:H4 associated enterocolitis participated in the study at the time of hospital discharge. The mean age of patients was 43 ± 2 years, 37 females and 24 males. 48 patients participated in follow up 1 [FU 1], 34 patients in follow up 2 [FU 2], 23 patients in follow up 3 [FU 3] and 18 patients in follow up 4 [FU 4]. Out of 61 patients discharged from the hospital and included in the study, 54 [84%] were examined at least at one additional follow up. Serum creatinine decreased significantly between discharge and FU 1 from 1.3 ± 0.1 mg/dl to 0.7 ± 0.1 mg/dl [p = 0.0045]. From FU 1 until FU 4, no further change in creatinine levels could be observed. The patients need of antihypertensive medications decreased significantly [p = 0.0005] between discharge and FU 1 after four months. From FU 1 until FU 3, 24 months later, no further significant change in antihypertensive treatment was observed.
Our findings suggest that patients free of pathological findings at time of discharge do not need a specific follow up. Patients with persistent health problems at hospital discharge should be clinically monitored over four months to evaluate chronic organ damage. Progressive or new emerging renal damage could not be observed over time in any patient.
产志贺毒素的O157:H7肠出血性大肠杆菌[STEC/EHEC]是与感染性出血性结肠炎相关的溶血性尿毒综合征[HUS]的最常见病因。几乎所有关于EHEC感染长期治疗的建议均指该菌株。2011年北欧的疫情是由O104:H4血清型引起的首例如此规模的疫情。我们报告了2011年春季确诊为有症状EHEC O104:H4感染的61例患者的3.5年随访情况。
对O104感染的患者进行单中心前瞻性观察研究，在四个时间点进行随访：4个月、12个月、24个月和36个月。这些数据包括患者病史、临床检查结果及并发症。
61例患有EHEC O104:H4相关性小肠结肠炎的患者在出院时参与了本研究。患者平均年龄为43±2岁，女性37例，男性24例。48例患者参与了随访1[FU 1]，34例患者参与了随访2[FU 2]，23例患者参与了随访3[FU 3]，18例患者参与了随访4[FU 4]。在出院并纳入研究的61例患者中，54例（84%）至少在一次额外随访中接受了检查。出院时与FU 1之间血清肌酐显著下降，从1.3±0.1mg/dl降至0.7±0.1mg/dl[p = 0.0045]。从FU 1到FU 4，未观察到肌酐水平有进一步变化。出院后4个月，患者对抗高血压药物的需求显著下降[p =
