Low incidence of colonic complications after severe Shiga toxin-producing E. coli O104:H4 infection
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Low incidence of colonic complications after severe Shiga toxin-producing E. coli O104:H4 infection. / Fründt, Thorben; Leuffert, Julia; Groth, Stefan; Rösch, Thomas; Steurer, Stefan; Lohse, Ansgar W; Ullrich, Sebastian; Lüth, Stefan.
In: Z GASTROENTEROL, Vol. 60, No. 7, 07.2022, p. 1104-1110.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Low incidence of colonic complications after severe Shiga toxin-producing E. coli O104:H4 infection
AU - Fründt, Thorben
AU - Leuffert, Julia
AU - Groth, Stefan
AU - Rösch, Thomas
AU - Steurer, Stefan
AU - Lohse, Ansgar W
AU - Ullrich, Sebastian
AU - Lüth, Stefan
N1 - Thieme. All rights reserved.
PY - 2022/7
Y1 - 2022/7
N2 - BACKGROUND: In summer 2011, Shiga toxin producing Escherichia coli (EHEC) serotype O104:H4 caused the most severe EHEC outbreak in Germany to date. The case of a previously recovered patient with symptomatic postinflammatory colonic stenosis following EHEC- infection prompted us to conduct a prospective study to assess the macro- and microscopic intestinal long-term damage in a cohort of patients who had suffered from severe EHEC colitis.METHODS: Following EHEC infection in 2011, 182 patients were offered to participate in this study between January 2013 and October 2014 as part of the post-inpatient follow-up care at the University Medical Center Hamburg-Eppendorf and to undergo colonoscopy with stepwise biopsies. Prior to colonoscopy, medical history and persistent post-infectious complaints were assessed.RESULTS: Out of 182 patients, 22 (12%) participated in the study, 18 (82%) were female. All patients had been hospitalized due severe EHEC enterocolitis: 20 patients (90%) had subsequently developed hemolytic uremic syndrome (HUS), 16 patients (72%) had additionally required dialysis. On assessment prior to colonoscopy, all patients denied any abdominal complaints before EHEC-infection but 8 (36%) patients reported persistent post-infectious symptoms. According to the ROME IV criteria, 4 (18%) patients met the definition for post-infectious irritable bowel syndrome (PI-IBS). In all patients with persistent symptoms, colonoscopies and histological examination were unremarkable. Only in one symptom-free patient, biopsy revealed a locally limited cryptitis of the caecum, while all patients without complaints had inconspicuous histological and endoscopical findings.CONCLUSION: Following infection colonic stenosis is a serious but rare long-term complication in patients who had suffered from severe enterocolitis. However, a significant proportion of these patients develop PI-IBS.
AB - BACKGROUND: In summer 2011, Shiga toxin producing Escherichia coli (EHEC) serotype O104:H4 caused the most severe EHEC outbreak in Germany to date. The case of a previously recovered patient with symptomatic postinflammatory colonic stenosis following EHEC- infection prompted us to conduct a prospective study to assess the macro- and microscopic intestinal long-term damage in a cohort of patients who had suffered from severe EHEC colitis.METHODS: Following EHEC infection in 2011, 182 patients were offered to participate in this study between January 2013 and October 2014 as part of the post-inpatient follow-up care at the University Medical Center Hamburg-Eppendorf and to undergo colonoscopy with stepwise biopsies. Prior to colonoscopy, medical history and persistent post-infectious complaints were assessed.RESULTS: Out of 182 patients, 22 (12%) participated in the study, 18 (82%) were female. All patients had been hospitalized due severe EHEC enterocolitis: 20 patients (90%) had subsequently developed hemolytic uremic syndrome (HUS), 16 patients (72%) had additionally required dialysis. On assessment prior to colonoscopy, all patients denied any abdominal complaints before EHEC-infection but 8 (36%) patients reported persistent post-infectious symptoms. According to the ROME IV criteria, 4 (18%) patients met the definition for post-infectious irritable bowel syndrome (PI-IBS). In all patients with persistent symptoms, colonoscopies and histological examination were unremarkable. Only in one symptom-free patient, biopsy revealed a locally limited cryptitis of the caecum, while all patients without complaints had inconspicuous histological and endoscopical findings.CONCLUSION: Following infection colonic stenosis is a serious but rare long-term complication in patients who had suffered from severe enterocolitis. However, a significant proportion of these patients develop PI-IBS.
U2 - 10.1055/a-1545-5322
DO - 10.1055/a-1545-5322
M3 - SCORING: Journal article
C2 - 34820797
VL - 60
SP - 1104
EP - 1110
JO - Z GASTROENTEROL
JF - Z GASTROENTEROL
SN - 0044-2771
IS - 7
ER -