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Duration of fecal shedding of Shiga toxin-producing Escherichia coli O104:H4 in patients infected during the 2011 outbreak in Germany

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Duration of fecal shedding of Shiga toxin-producing Escherichia coli O104:H4 in patients infected during the 2011 outbreak in Germany : a multicenter study. / Vonberg, Ralf P; Höhle, Michael; Aepfelbacher, Martin; Bange, Franz C; Belmar Campos, Cristina; Claussen, Katja; Christner, Martin; Cramer, Jakob P; Haller, Hermann; Hornef, Mathias; Fickenscher, Helmut; Zimmermann-Fraedrich, Katharina; Knobloch, Johannes K; Kühbacher, Tanja; Manns, Michael P; Nitschke, Martin; Peters, Georg; Pulz, Matthias; Rohde, Holger; Roseland, Rahel T; Sayk, Friedhelm; Schaumburg, Frieder; Schöcklmann, Harald O; Schubert, Sabine; Solbach, Werner; Karch, Helge; Suerbaum, Sebastian.

in: CLIN INFECT DIS, Jahrgang 56, Nr. 8, 01.04.2013, S. 1132-40.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Vonberg, RP, Höhle, M, Aepfelbacher, M, Bange, FC, Belmar Campos, C, Claussen, K, Christner, M, Cramer, JP, Haller, H, Hornef, M, Fickenscher, H, Zimmermann-Fraedrich, K, Knobloch, JK, Kühbacher, T, Manns, MP, Nitschke, M, Peters, G, Pulz, M, Rohde, H, Roseland, RT, Sayk, F, Schaumburg, F, Schöcklmann, HO, Schubert, S, Solbach, W, Karch, H & Suerbaum, S 2013, 'Duration of fecal shedding of Shiga toxin-producing Escherichia coli O104:H4 in patients infected during the 2011 outbreak in Germany: a multicenter study', CLIN INFECT DIS, Jg. 56, Nr. 8, S. 1132-40. https://doi.org/10.1093/cid/cis1218

APA

Vonberg, R. P., Höhle, M., Aepfelbacher, M., Bange, F. C., Belmar Campos, C., Claussen, K., Christner, M., Cramer, J. P., Haller, H., Hornef, M., Fickenscher, H., Zimmermann-Fraedrich, K., Knobloch, J. K., Kühbacher, T., Manns, M. P., Nitschke, M., Peters, G., Pulz, M., Rohde, H., ... Suerbaum, S. (2013). Duration of fecal shedding of Shiga toxin-producing Escherichia coli O104:H4 in patients infected during the 2011 outbreak in Germany: a multicenter study. CLIN INFECT DIS, 56(8), 1132-40. https://doi.org/10.1093/cid/cis1218

Vancouver

Vonberg RP, Höhle M, Aepfelbacher M, Bange FC, Belmar Campos C, Claussen K et al. Duration of fecal shedding of Shiga toxin-producing Escherichia coli O104:H4 in patients infected during the 2011 outbreak in Germany: a multicenter study. CLIN INFECT DIS. 2013 Apr 1;56(8):1132-40. https://doi.org/10.1093/cid/cis1218

Bibtex

@article{59d59b237a644abf89739c092857f634,
title = "Duration of fecal shedding of Shiga toxin-producing Escherichia coli O104:H4 in patients infected during the 2011 outbreak in Germany: a multicenter study",
abstract = "BACKGROUND: In May-July 2011, Germany experienced a large food-borne outbreak of Shiga toxin 2-producing Escherichia coli (STEC O104:H4) with 3842 cases, including 855 cases with hemolytic uremic syndrome (HUS) and 53 deaths.METHODS: A multicenter study was initiated in 5 university hospitals to determine pathogen shedding duration. Diagnostics comprised culture on selective media, toxin enzyme-linked immunosorbent assay, and polymerase chain reaction. Results were correlated with clinical and epidemiologic findings. Testing for pathogen excretion was continued after discharge of the patient.RESULTS: A total of 321 patients (104 male, 217 female) were included (median age, 40 years [range, 1-89 days]). Median delay from onset of symptoms to hospitalization was 4 days (range, 0-17 days). Two hundred nine patients presented with HUS. The estimate for the median duration of shedding was 17-18 days. Some patients remained STEC O104:H4 positive until the end of the observation time (maximum observed shedding duration: 157 days). There was no significant influence of sex on shedding duration. Patients presenting with HUS had a significantly shortened shedding duration (median, 13-14 days) compared to non-HUS patients (median, 33-34 days). Antimicrobial treatment was also significantly associated with reduced shedding duration. Children (age≤15 years) had longer shedding durations than adults (median, 35-41 vs 14-15 days).CONCLUSIONS: STEC O104:H4 is usually eliminated from the human gut after 1 month, but may sometimes be excreted for several months. Proper follow-up of infected patients is important to avoid further pathogen spread.",
keywords = "Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Bacterial Shedding, Child, Child, Preschool, Disease Outbreaks, Enterohemorrhagic Escherichia coli, Escherichia coli Infections, Feces, Female, Germany, Hemolytic-Uremic Syndrome, Humans, Infant, Male, Middle Aged, Multivariate Analysis, Sex Factors, Statistics, Nonparametric, Young Adult",
author = "Vonberg, {Ralf P} and Michael H{\"o}hle and Martin Aepfelbacher and Bange, {Franz C} and {Belmar Campos}, Cristina and Katja Claussen and Martin Christner and Cramer, {Jakob P} and Hermann Haller and Mathias Hornef and Helmut Fickenscher and Katharina Zimmermann-Fraedrich and Knobloch, {Johannes K} and Tanja K{\"u}hbacher and Manns, {Michael P} and Martin Nitschke and Georg Peters and Matthias Pulz and Holger Rohde and Roseland, {Rahel T} and Friedhelm Sayk and Frieder Schaumburg and Sch{\"o}cklmann, {Harald O} and Sabine Schubert and Werner Solbach and Helge Karch and Sebastian Suerbaum",
year = "2013",
month = apr,
day = "1",
doi = "10.1093/cid/cis1218",
language = "English",
volume = "56",
pages = "1132--40",
journal = "CLIN INFECT DIS",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "8",

}

RIS

TY - JOUR

T1 - Duration of fecal shedding of Shiga toxin-producing Escherichia coli O104:H4 in patients infected during the 2011 outbreak in Germany

T2 - a multicenter study

AU - Vonberg, Ralf P

AU - Höhle, Michael

AU - Aepfelbacher, Martin

AU - Bange, Franz C

AU - Belmar Campos, Cristina

AU - Claussen, Katja

AU - Christner, Martin

AU - Cramer, Jakob P

AU - Haller, Hermann

AU - Hornef, Mathias

AU - Fickenscher, Helmut

AU - Zimmermann-Fraedrich, Katharina

AU - Knobloch, Johannes K

AU - Kühbacher, Tanja

AU - Manns, Michael P

AU - Nitschke, Martin

AU - Peters, Georg

AU - Pulz, Matthias

AU - Rohde, Holger

AU - Roseland, Rahel T

AU - Sayk, Friedhelm

AU - Schaumburg, Frieder

AU - Schöcklmann, Harald O

AU - Schubert, Sabine

AU - Solbach, Werner

AU - Karch, Helge

AU - Suerbaum, Sebastian

PY - 2013/4/1

Y1 - 2013/4/1

N2 - BACKGROUND: In May-July 2011, Germany experienced a large food-borne outbreak of Shiga toxin 2-producing Escherichia coli (STEC O104:H4) with 3842 cases, including 855 cases with hemolytic uremic syndrome (HUS) and 53 deaths.METHODS: A multicenter study was initiated in 5 university hospitals to determine pathogen shedding duration. Diagnostics comprised culture on selective media, toxin enzyme-linked immunosorbent assay, and polymerase chain reaction. Results were correlated with clinical and epidemiologic findings. Testing for pathogen excretion was continued after discharge of the patient.RESULTS: A total of 321 patients (104 male, 217 female) were included (median age, 40 years [range, 1-89 days]). Median delay from onset of symptoms to hospitalization was 4 days (range, 0-17 days). Two hundred nine patients presented with HUS. The estimate for the median duration of shedding was 17-18 days. Some patients remained STEC O104:H4 positive until the end of the observation time (maximum observed shedding duration: 157 days). There was no significant influence of sex on shedding duration. Patients presenting with HUS had a significantly shortened shedding duration (median, 13-14 days) compared to non-HUS patients (median, 33-34 days). Antimicrobial treatment was also significantly associated with reduced shedding duration. Children (age≤15 years) had longer shedding durations than adults (median, 35-41 vs 14-15 days).CONCLUSIONS: STEC O104:H4 is usually eliminated from the human gut after 1 month, but may sometimes be excreted for several months. Proper follow-up of infected patients is important to avoid further pathogen spread.

AB - BACKGROUND: In May-July 2011, Germany experienced a large food-borne outbreak of Shiga toxin 2-producing Escherichia coli (STEC O104:H4) with 3842 cases, including 855 cases with hemolytic uremic syndrome (HUS) and 53 deaths.METHODS: A multicenter study was initiated in 5 university hospitals to determine pathogen shedding duration. Diagnostics comprised culture on selective media, toxin enzyme-linked immunosorbent assay, and polymerase chain reaction. Results were correlated with clinical and epidemiologic findings. Testing for pathogen excretion was continued after discharge of the patient.RESULTS: A total of 321 patients (104 male, 217 female) were included (median age, 40 years [range, 1-89 days]). Median delay from onset of symptoms to hospitalization was 4 days (range, 0-17 days). Two hundred nine patients presented with HUS. The estimate for the median duration of shedding was 17-18 days. Some patients remained STEC O104:H4 positive until the end of the observation time (maximum observed shedding duration: 157 days). There was no significant influence of sex on shedding duration. Patients presenting with HUS had a significantly shortened shedding duration (median, 13-14 days) compared to non-HUS patients (median, 33-34 days). Antimicrobial treatment was also significantly associated with reduced shedding duration. Children (age≤15 years) had longer shedding durations than adults (median, 35-41 vs 14-15 days).CONCLUSIONS: STEC O104:H4 is usually eliminated from the human gut after 1 month, but may sometimes be excreted for several months. Proper follow-up of infected patients is important to avoid further pathogen spread.

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Bacterial Shedding

KW - Child

KW - Child, Preschool

KW - Disease Outbreaks

KW - Enterohemorrhagic Escherichia coli

KW - Escherichia coli Infections

KW - Feces

KW - Female

KW - Germany

KW - Hemolytic-Uremic Syndrome

KW - Humans

KW - Infant

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Sex Factors

KW - Statistics, Nonparametric

KW - Young Adult

U2 - 10.1093/cid/cis1218

DO - 10.1093/cid/cis1218

M3 - SCORING: Journal article

C2 - 23300241

VL - 56

SP - 1132

EP - 1140

JO - CLIN INFECT DIS

JF - CLIN INFECT DIS

SN - 1058-4838

IS - 8

ER -