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More information about EHEC infections

The bacterium Escherichia (E.) coli is commonly found in the gut of humans and animals. Most of the E. coli strains are harmless. However, there are some which are able to induce clinical symptoms in humans.

Enterohaemorrhagic E. coli (EHEC) are able to induce haemorrhagic colitis and haemolytic-uraemic syndrome (HUS) – the most common cause of acute renal failure mainly in young children. EHEC are characterized by the production of cytotoxins, so called Shiga toxins. Shiga toxins are divided in two subgroups, stx1 and stx2. Severe clinical courses such as HUS are usually caused by stx2-producing EHEC. The identification of the toxin genes is essential for the diagnostics of EHEC infections. The detection of eae gene which encodes for the protein intimin is also important. Intimin enables the pathogen to adhere to intestinal epithelial cells.

EHEC are usually transmitted to humans through the consumption of contaminated food or water. EHEC are highly contagious. A low number of pathogen is enough.

Clinical course
After the infection with EHEC bacteria, clinical symptoms such as bloody or bloodless diarrhea in combination with abdominal pain and vomiting usually develop after two to ten days. HUS is a serious complication that occurs in 5 to 10% of symptomatic EHEC infections and is the most common cause of acute kidney failure in young children.

Although EHEC are usually susceptible to antibiotic drugs, an antibacterial treatment is not recommended since it may lead to increased toxin secretion. Thus, treatment of EHEC is mainly supportive. In the case of HUS, dialysis is required to cleanse the body of uremic toxins and to maintain fluid and electrolyte balance.

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