Sociodemographic and clinical risk factors for paediatric typical haemolytic uraemic syndrome: retrospective cohort study

Adams, Natalie, Byrne, Lisa, Rose, Tanith, Adak, Bob, Jenkins, Claire, Charlett, Andre, Violato, Mara, O'Brien, Sarah ORCID: 0000-0003-2896-8999, Whitehead, Margaret ORCID: 0000-0001-5614-6576, Barr, Benjamin ORCID: 0000-0002-4208-9475
et al (show 2 more authors) (2019) Sociodemographic and clinical risk factors for paediatric typical haemolytic uraemic syndrome: retrospective cohort study. BMJ PAEDIATRICS OPEN, 3 (1). e000465-.

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<h4>Objectives</h4>Haemolytic uraemic syndrome (HUS) following Shiga toxin-producing <i>Escherichia coli</i> (STEC) infection is the the most common cause of acute renal failure among children in the UK. This study explored differential progression from STEC to HUS by social, demographic and clinical risk factors.<h4>Methods</h4>We undertook a retrospective cohort study linking two datasets. We extracted data on paediatric STEC and HUS cases identified in the Public Health England National Enhanced Surveillance System for STEC and British Paediatric Surveillance Unit HUS surveillance from 1 October 2011 to 31 October 2014. Using logistic regression, we estimated the odds of HUS progression by risk factors.<h4>Results</h4>1059 paediatric STEC cases were included in the study, of which 207 (19.55%, 95% CI 17% to 22%) developed HUS. In the fully adjusted model, the odds of progression to HUS were highest in those aged 1-4 years (OR 4.93, 95% CI 2.30 to 10.56, compared with 10-15 years), were infected with an Shiga toxin (<i>stx)</i> 2-only strain (OR 5.92, 95% CI 2.49 to 14.10), were prescribed antibiotics (OR 8.46, 95% CI 4.71 to 15.18) and had bloody diarrhoea (OR 3.56, 95% CI 2.04 to 6.24) or vomiting (OR 4.47, 95% CI 2.62 to 7.63), but there was no association with progression to HUS by socioeconomic circumstances or rurality.<h4>Conclusion</h4>Combining data from an active clinical surveillance system for HUS with the national enhanced STEC surveillance system suggests that 20% of diagnosed paediatric STEC infections in England resulted in HUS. No relationship was found with socioeconomic status or rurality of cases, but differences were demonstrated by age, <i>stx</i> type and presenting symptoms.

Item Type: Article
Uncontrolled Keywords: epidemiology, infectious diseases
Depositing User: Symplectic Admin
Date Deposited: 02 Jan 2020 16:34
Last Modified: 19 Jan 2023 00:11
DOI: 10.1136/bmjpo-2019-000465
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