2000. Clinical characteristics and prognosis of patients with Shiga toxin-producing Escherichia coli hemolytic uremic syndrome and encephalopathy: a nationwide observational study in Japan. (15th December 2022)

• Record Type: Journal Article
• Authors: Myojin, Shota; Michihata, Nobuaki; Shoji, Kensuke; Takanashi, Jun-ichi; Matsui, Hiroki; Fushimi, Kiyohide; Miyairi, Isao; Yasunaga, Hideo
• Is Part Of: Open forum infectious diseases. Volume 9:(2022)Supplement 2
• Publication Date: 2022-12-15
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofac492.1625
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Shiga toxin-producing Escherichia coli (STEC) may cause hemolytic uremic syndrome (STEC-HUS) and encephalopathy which possibly lead to neurological sequelae and mortality. However, the detailed epidemiology of this disease remains unclear due to its low frequency. This study aimed to describe the characteristics, demographics, and mortality of patients with STEC-HUS using a nationwide database. Methods: We performed a retrospective cohort study using the Diagnosis Procedure Combination database, which includes approximately half of acute-care inpatients across Japan. We enrolled patients who were hospitalized for STEC-HUS from July 2010 to March 2020. We defined patients with unfavorable outcomes as any of the following at discharge: in-hospital death within three months, tracheostomy, mechanical ventilation, dialysis, and rehabilitation. Results: This study included 655 patients with STEC-HUS (median age, 7 years). 62 patients (9.5%) were admitted to intensive care units within 2 days of admission. A total of 125 (19.1%) patients had any one of the composite unfavorable outcomes: 24 (3.7%) in-hospital death within 3 months, 9 (1.4%) tracheostomy during hospitalization, 24 (3.7%) mechanical ventilation at discharge, 22 (3.4%) dialysis at discharge, and 95 (14.5%) rehabilitation at discharge. Thirty-one patients (4.7%) developed STEC-HUS related acute encephalopathy. Conclusion: Regardless of advances in multidisciplinary medicine, we found STEC-HUS remains a poor prognostic condition. Disclosures: All Authors : No reported disclosures.