2009 - 2023年英格兰溶血性尿毒症综合征的流行病学：国家监测数据分析

The epidemiology of haemolytic uraemic syndrome in England, 2009-2023: An analysis of national surveillance data.

作者信息

McGeoch Luke J, Quinn Orlagh, Douglas Amy, Sawyer Clare, Jenkins Claire, Balasegaram Sooria

机构信息

Field Service South-East and London, Health Protection in the Regions Division, UK Health Security Agency, London, England, UK; Field Epidemiology Training Programme, UK Health Security Agency, London, England, UK.

Gastrointestinal Infections, Food Safety and One Health Division, Clinical and Public Health Group, UK Health Security Agency, London, England, UK.

出版信息

J Infect. 2025 Aug;91(2):106551. doi: 10.1016/j.jinf.2025.106551. Epub 2025 Jul 14.

DOI:10.1016/j.jinf.2025.106551

PMID:40669773

Abstract

OBJECTIVES

Haemolytic uraemic syndrome (HUS) is a serious multi-system disorder, predominantly caused by Shiga toxin-producing Escherichia coli (STEC). We aimed to describe the epidemiology of HUS in England, including characteristics associated with HUS among STEC cases.

METHODS

Enhanced surveillance questionnaire (ESQ) and microbiological data were extracted for HUS and laboratory-confirmed STEC cases reported through national surveillance between 2009-2023. HUS incidence rates were computed. Trends in demographic, clinical, microbiological and exposure characteristics were described for STEC cases with (STEC-HUS) and without (non-HUS STEC) HUS, with complete ESQs. Associations with HUS were assessed using multivariable logistic regression.

RESULTS

There were 991 HUS cases, 601 STEC-HUS cases and 12,916 non-HUS STEC cases. Between 2009-2023, serogroup O26 positivity increased from 3.3% to 48.6% among STEC-HUS cases, and 0.0% to 16.0% among non-HUS STEC cases. Characteristics associated with HUS included serogroup O26 (OR 2.30, 95% CI 1.68-3.11), stx2a (2.66, 2.10-3.37), stx2d (5.48, 2.41-11.66), eae (OR 3.00, 1.60-5.80), vomiting (4.78, 3.83-5.99), younger age, bloody diarrhoea, unpasteurised dairy consumption, and antibiotic use.

CONCLUSIONS

STEC O26 is the most common serogroup detected in HUS in England. We recommend efforts to improve surveillance of non-O157 serogroups and investigate drivers of STEC O26 infection and its relationship with HUS.

摘要

目的

溶血尿毒综合征（HUS）是一种严重的多系统疾病，主要由产志贺毒素大肠杆菌（STEC）引起。我们旨在描述英格兰HUS的流行病学情况，包括STEC病例中与HUS相关的特征。

方法

提取2009年至2023年通过国家监测报告的HUS及实验室确诊的STEC病例的强化监测问卷（ESQ）和微生物学数据。计算HUS发病率。对有（STEC-HUS）和无（非HUS STEC）HUS的STEC病例的人口统计学、临床、微生物学和暴露特征趋势进行描述，并填写完整的ESQ。使用多变量逻辑回归评估与HUS的关联。

结果

共有991例HUS病例、601例STEC-HUS病例和12916例非HUS STEC病例。在2009年至2023年期间，STEC-HUS病例中O26血清群阳性率从3.3%升至48.6%，非HUS STEC病例中从0.0%升至16.0%。与HUS相关的特征包括O26血清群（比值比2.30，95%置信区间1.68 - 3.11）、stx2a（2.66，2.10 - 3.37）、stx2d（5.48，2.41 - 11.66）、eae（比值比3.00，1.60 - 5.80）、呕吐（4.78，3.83 - 5.99）、年龄较小、血性腹泻、食用未巴氏杀菌的乳制品以及使用抗生素。