Shiga Toxin-Associated Hemolytic Uremic Syndrome in Adults, France, 2009-2017

Benoit Travert (1, 2) , Antoine Dossier (1) , Matthieu Jamme (3, 4) , Aurelie Cointe (5) , Yahsou Delmas (6) , Sandrine Malot (2) , Alain Wynckel (7) , Amelie Seguin (8) , Claire Presne (9) , Miguel Hie (10, 11) , Ygal Benhamou (12, 13) , David Ribes (14) , Gabriel Choukroun (9, 15) , Steven Grange (2) , Alexandre Hertig (16) , Emilie Cornec-Le Gall (17) , Lionel Galicier (2, 18, 19) , Eric Daugas (1, 20) , Lila Bouadma (5, 1) , Francois-Xavier Weill (21) , Elie Azoulay (22) , Fadi Fakhouri , Agnes Veyradier , Stephane Bonacorsi , Julien Hogan , Veronique Fremeaux-Bacchi , Eric Rondeau , Patricia Mariani-Kurkdjian , Paul Coppo

1 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
2 CHU Saint-Antoine [AP-HP]
3 CESP - Centre de recherche en épidémiologie et santé des populations
4 AFSOS and Hôpital Privé de l'Ouest Parisien
5 IAME (UMR_S_1137 / U1137) - Infection, Anti-microbiens, Modélisation, Evolution
6 CHU Bordeaux
7 Hôpital universitaire Robert Debré [Reims]
8 CHU Nantes - Centre Hospitalier Universitaire de Nantes
9 CHU Amiens-Picardie
10 CHU Pitié-Salpêtrière [AP-HP]
11 CIMI - Centre d'Immunologie et des Maladies Infectieuses
12 Service de Médecine Interne [CHU Rouen]
13 EnVI - Endothélium, valvulopathies et insuffisance cardiaque
14 Département de Néphrologie et Transplantation d'organes [CHU Toulouse]
15 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517
16 CHU Tenon [AP-HP]
17 GGB - Génétique, génomique fonctionnelle et biotechnologies (UMR 1078)
18 UFR Médecine UPCité - UFR Médecine [Santé] - Université Paris Cité
19 Service d'Immunopathologie [Hôpital Saint-Louis, Paris]
20 CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation
21 IP - Institut Pasteur [Paris]
22 AP-HP - Hopital Saint-Louis [AP-HP]

We conducted a retrospective study on hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli (STEC) in 96 adults enrolled in the cohort of the National Reference Center for Thrombotic Microangiopathies network in France during 2009-2017. Most infections were caused by STEC strains not belonging to the O157 or O104 serogroups. Thirty (31.3%) patients had multiple risk factors for thrombotic microangiopathy. In total, 61 (63.5%) patients required dialysis, 50 (52.1%) had a serious neurologic complication, 34 (35.4%) required mechanical ventilation, and 19 (19.8%) died during hospitalization. We used multivariate analysis to determine that the greatest risk factors for death were underlying immunodeficiency (hazard ratio 3.54) and severe neurologic events (hazard ratio 3.40). According to multivariate analysis and propensity score-matching, eculizuma b treatment was not associated with survival. We found that underlying conditions, especially immunodeficiency, are strongly associated with decreased survival in adults who have hemolytic uremic syndrome caused by STEC.

Domaines: Sciences du Vivant [q-bio]

Benoit Travert, Antoine Dossier, Matthieu Jamme, Aurelie Cointe, Yahsou Delmas, et al.. Shiga Toxin-Associated Hemolytic Uremic Syndrome in Adults, France, 2009-2017. Emerging Infectious Diseases, 2021, 27 (7), pp.1876-1885. ⟨10.3201/eid2707.204638⟩. ⟨hal-03572956⟩