Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.
Università della Svizzera Italiana, Via Buffi 13, 6900, Lugano, Switzerland.
J Nephrol. 2018 Dec;31(6):919-924. doi: 10.1007/s40620-018-0543-x. Epub 2018 Oct 17.
Intestinal infections caused by a shigatoxin-positive Escherichia coli (mostly of the serogroups O26, O45, O103, O111, O121, O145 and especially O157) are a common cause of hemolytic-uremic syndrome. Hemolytic-uremic syndrome was first linked with an E. coli urinary tract infection 40 years ago.
We conducted a systematic review of the literature addressing the association between E. coli urinary tract infection and hemolytic-uremic syndrome.
For the final analysis, we retained 23 original reports published since 1979. Five unselected pediatric case series addressed the possible occurrence of hemolytic-uremic syndrome after an acute symptomatic E. coli urinary tract infection among 266 cases and found the mentioned association in 8 (3.0%) cases. We also found 28 individual cases (17 females and 11 males) of hemolytic-uremic syndrome preceded by an E. coli urinary tract infection: 16 children aged from 2 days to 6.0 years and 12 adults aged from 22 to 75 years. Testing for shigatoxin, performed in 19 cases, was positive in 15 cases. E. coli serotyping was performed in 18 cases: testing for serotype O157, O103 and O145 was positive in one, one and two cases, respectively, while testing for serotype O26, O45, O111 and O121 was always negative.
Hemolytic-uremic syndrome rarely occurs after an acute E. coli urinary tract infection. It affects both children and adults and is mostly caused by germs that are shigatoxin-positive.
由志贺毒素阳性大肠杆菌（主要血清型为 O26、O45、O103、O111、O121、O145，尤其是 O157）引起的肠道感染是溶血性尿毒综合征的常见病因。40 年前，溶血性尿毒综合征首次与大肠杆菌尿路感染相关联。
我们对文献进行了系统综述，以探讨大肠杆菌尿路感染与溶血性尿毒综合征之间的关系。
最终分析纳入了自 1979 年以来发表的 23 篇原始报告。5 项未选择的儿科病例系列研究了 266 例急性症状性大肠杆菌尿路感染后可能发生溶血性尿毒综合征的情况，发现 8 例（3.0%）存在上述关联。我们还发现了 28 例由大肠杆菌尿路感染引起的溶血性尿毒综合征的个案病例（17 名女性和 11 名男性）：16 名儿童年龄从 2 天至 6.0 岁，12 名成人年龄从 22 岁至 75 岁。在 19 例病例中进行了志贺毒素检测，其中 15 例为阳性。对 18 例大肠杆菌进行了血清型检测：1 例、1 例和 2 例分别为 O157、O103 和 O145 血清型阳性，而 O26、O45、O111 和 O121 血清型检测均为阴性。
溶血性尿毒综合征在急性大肠杆菌尿路感染后很少发生。它影响儿童和成人，主要由志贺毒素阳性的细菌引起。
