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      Risk Factors for Sporadic Shiga Toxin–producing Escherichia coli Infections in Children, Argentina1

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          Abstract

          These infections can be prevented by avoiding known risk factors.

          Abstract

          We evaluated risk factors for sporadic Shiga toxin–producing Escherichia coli (STEC) infection among children in Argentina. We conducted a prospective case–control study in 2 sites and enrolled 150 case-patients and 299 controls. The median age of case-patients was 1.8 years; 58% were girls. Serotype O157:H7 was the most commonly isolated STEC. Exposures associated with infection included eating undercooked beef, living in or visiting a place with farm animals, and contact with a child <5 years of age with diarrhea. Protective factors included the respondent reporting that he or she always washed hands after handling raw beef and the child eating more than the median number of fruits and vegetables. Many STEC infections in children could be prevented by avoiding consumption of undercooked beef, limiting exposure to farm animals and their environment, not being exposed to children with diarrhea, and washing hands after handling raw beef.

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          Most cited references37

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          Detection and characterization of Shiga toxigenic Escherichia coli by using multiplex PCR assays for stx1, stx2, eaeA, enterohemorrhagic E. coli hlyA, rfbO111, and rfbO157.

          Shiga toxigenic Escherichia coli (STEC) comprises a diverse group of organisms capable of causing severe gastrointestinal disease in humans. Within the STEC family, certain strains appear to be of greater virulence for humans, for example, those belonging to serogroups O111 and O157 and those with particular combinations of other putative virulence traits. We have developed two multiplex PCR assays for the detection and genetic characterization of STEC in cultures of feces or foodstuffs. Assay 1 utilizes four PCR primer pairs and detects the presence of stx1, stx2 (including variants of stx2), eaeA, and enterohemorrhagic E. coli hlyA, generating amplification products of 180, 255, 384, and 534 bp, respectively. Assay 2 uses two primer pairs specific for portions of the rfb (O-antigen-encoding) regions of E. coli serotypes O157 and O111, generating PCR products of 259 and 406 bp, respectively. The two assays were validated by testing 52 previously characterized STEC strains and observing 100% agreement with previous results. Moreover, assay 2 did not give a false-positive O157 reaction with enteropathogenic E. coli strains belonging to clonally related serogroup O55. Assays 1 and 2 detected STEC of the appropriate genotype in primary fecal cultures from five patients with hemolytic-uremic syndrome and three with bloody diarrhea. Thirty-one other primary fecal cultures from patients without evidence of STEC infection were negative.
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            The epidemiology of infections caused by Escherichia coli O157:H7, other enterohemorrhagic E. coli, and the associated hemolytic uremic syndrome.

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              Escherichia coli O157:H7 and the hemolytic-uremic syndrome.

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                Author and article information

                Journal
                Emerg Infect Dis
                EID
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                1080-6040
                1080-6059
                May 2008
                : 14
                : 5
                : 763-771
                Affiliations
                [* ]Instituto Nacional de Enfermedades Infecciosas, Buenos Aires, Argentina
                []Centro Nacional de Endemoepidemias, Buenos Aires, Argentina
                []Centers for Disease Control and Prevention, Atlanta, Georgia, USA
                [§ ]Hospital Nacional de Pediatría, Buenos Aires, Argentina
                []Hospital Pediátrico, Mendoza, Argentina
                [# ]Ministerio de Desarrollo Social y Salud, Mendoza, Argentina
                Author notes
                Address for correspondence: Patricia M. Griffin, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A38, Atlanta, GA 30333, USA; email: pgriffin@ 123456cdc.gov
                Article
                07-1050
                10.3201/eid1405.071050
                2600246
                18439359
                7be9f5cb-9609-4ebb-9522-5c3a68ed97bc
                History
                Categories
                Research

                Infectious disease & Microbiology
                case-control study,argentina,epidemiology,transmission,research,human,hemolytic uremic syndrome (hus),shiga toxin–producing escherichia coli,e. coli o157,risk factors

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