Escherichia coli O157 lipopolysaccharide (LPS)-specific antibodies were measured in sequential serum samples from 131 children with serologically defined E. coli O157-associated hemolytic-uremic syndrome (HUS), using an enzyme immunoassay. On the basis of evaluation of 66 children with culture-proven E. coli O157 infection and serum samples from 132 age-matched control subjects, the assay showed a sensitivity of 95%, 88%, and 74% and a specificity of 99%, 99%, and 98% for IgM, IgA, and IgG, respectively. Anti-O157 LPS antibodies decreased below the cut-off levels in >50% of the children at 11 (IgM), 5 (IgA), and 11 weeks (IgG) after onset of diarrhea and 10, 4, and 10 weeks, respectively, after the onset of HUS. Children with enteropathic HUS fail to develop a long-lasting humoral immune response to the O157 antigen. Incomplete immunity to E. coli O157 may signal a risk for recurrent infections and has implications for serodiagnostic studies.
