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Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes

Treatment of Shiga toxin-producing Escherichia coli O157 (O157) diarrhea with antimicrobials might alter the risk of hemolytic uremic syndrome (HUS). However, full characterization of which antimicrobials might affect risk is lacking, particularly among adults. To inform clinical management, we cond...

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Autores principales: Mody, Rajal K., Hoekstra, Robert M., Scott, Magdalena Kendall, Dunn, John, Smith, Kirk, Tobin-D’Angelo, Melissa, Shiferaw, Beletshachew, Wymore, Katie, Clogher, Paula, Palmer, Amanda, Comstock, Nicole, Burzlaff, Kari, Lathrop, Sarah, Hurd, Sharon, Griffin, Patricia M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466573/
https://www.ncbi.nlm.nih.gov/pubmed/34576892
http://dx.doi.org/10.3390/microorganisms9091997
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author Mody, Rajal K.
Hoekstra, Robert M.
Scott, Magdalena Kendall
Dunn, John
Smith, Kirk
Tobin-D’Angelo, Melissa
Shiferaw, Beletshachew
Wymore, Katie
Clogher, Paula
Palmer, Amanda
Comstock, Nicole
Burzlaff, Kari
Lathrop, Sarah
Hurd, Sharon
Griffin, Patricia M.
author_facet Mody, Rajal K.
Hoekstra, Robert M.
Scott, Magdalena Kendall
Dunn, John
Smith, Kirk
Tobin-D’Angelo, Melissa
Shiferaw, Beletshachew
Wymore, Katie
Clogher, Paula
Palmer, Amanda
Comstock, Nicole
Burzlaff, Kari
Lathrop, Sarah
Hurd, Sharon
Griffin, Patricia M.
author_sort Mody, Rajal K.
collection PubMed
description Treatment of Shiga toxin-producing Escherichia coli O157 (O157) diarrhea with antimicrobials might alter the risk of hemolytic uremic syndrome (HUS). However, full characterization of which antimicrobials might affect risk is lacking, particularly among adults. To inform clinical management, we conducted a case-control study of residents of the FoodNet surveillance areas with O157 diarrhea during a 4-year period to assess antimicrobial class-specific associations with HUS among persons with O157 diarrhea. We collected data from medical records and patient interviews. We measured associations between treatment with agents in specific antimicrobial classes during the first week of diarrhea and development of HUS, adjusting for age and illness severity. We enrolled 1308 patients; 102 (7.8%) developed confirmed HUS. Antimicrobial treatment varied by age: <5 years (12.6%), 5–14 (11.5%), 15–39 (45.4%), ≥40 (53.4%). Persons treated with a β-lactam had higher odds of developing HUS (OR 2.80, CI 1.14–6.89). None of the few persons treated with a macrolide developed HUS, but the protective association was not statistically significant. Exposure to “any antimicrobial” was not associated with increased odds of HUS. Our findings confirm the risk of β-lactams among children with O157 diarrhea and extends it to adults. We observed a high frequency of inappropriate antimicrobial treatment among adults. Our data suggest that antimicrobial classes differ in the magnitude of risk for persons with O157 diarrhea.
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spelling pubmed-84665732021-09-27 Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes Mody, Rajal K. Hoekstra, Robert M. Scott, Magdalena Kendall Dunn, John Smith, Kirk Tobin-D’Angelo, Melissa Shiferaw, Beletshachew Wymore, Katie Clogher, Paula Palmer, Amanda Comstock, Nicole Burzlaff, Kari Lathrop, Sarah Hurd, Sharon Griffin, Patricia M. Microorganisms Article Treatment of Shiga toxin-producing Escherichia coli O157 (O157) diarrhea with antimicrobials might alter the risk of hemolytic uremic syndrome (HUS). However, full characterization of which antimicrobials might affect risk is lacking, particularly among adults. To inform clinical management, we conducted a case-control study of residents of the FoodNet surveillance areas with O157 diarrhea during a 4-year period to assess antimicrobial class-specific associations with HUS among persons with O157 diarrhea. We collected data from medical records and patient interviews. We measured associations between treatment with agents in specific antimicrobial classes during the first week of diarrhea and development of HUS, adjusting for age and illness severity. We enrolled 1308 patients; 102 (7.8%) developed confirmed HUS. Antimicrobial treatment varied by age: <5 years (12.6%), 5–14 (11.5%), 15–39 (45.4%), ≥40 (53.4%). Persons treated with a β-lactam had higher odds of developing HUS (OR 2.80, CI 1.14–6.89). None of the few persons treated with a macrolide developed HUS, but the protective association was not statistically significant. Exposure to “any antimicrobial” was not associated with increased odds of HUS. Our findings confirm the risk of β-lactams among children with O157 diarrhea and extends it to adults. We observed a high frequency of inappropriate antimicrobial treatment among adults. Our data suggest that antimicrobial classes differ in the magnitude of risk for persons with O157 diarrhea. MDPI 2021-09-21 /pmc/articles/PMC8466573/ /pubmed/34576892 http://dx.doi.org/10.3390/microorganisms9091997 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mody, Rajal K.
Hoekstra, Robert M.
Scott, Magdalena Kendall
Dunn, John
Smith, Kirk
Tobin-D’Angelo, Melissa
Shiferaw, Beletshachew
Wymore, Katie
Clogher, Paula
Palmer, Amanda
Comstock, Nicole
Burzlaff, Kari
Lathrop, Sarah
Hurd, Sharon
Griffin, Patricia M.
Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes
title Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes
title_full Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes
title_fullStr Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes
title_full_unstemmed Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes
title_short Risk of Hemolytic Uremic Syndrome Related to Treatment of Escherichia coli O157 Infection with Different Antimicrobial Classes
title_sort risk of hemolytic uremic syndrome related to treatment of escherichia coli o157 infection with different antimicrobial classes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466573/
https://www.ncbi.nlm.nih.gov/pubmed/34576892
http://dx.doi.org/10.3390/microorganisms9091997
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