This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ludwig, K. Articles by Müller-Wiefel, D. E. Search for Related Content PubMed PubMed Citation Articles by Ludwig, K. Articles by Müller-Wiefel, D. E.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, May 2002, p. 1773-1782, Vol. 40, No. 5
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.5.1773-1782.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Shiga Toxin-Producing Escherichia coli Infection and Antibodies against Stx2 and Stx1 in Household Contacts of Children with Enteropathic Hemolytic-Uremic Syndrome

Kerstin Ludwig,^1* Volkan Sarkim,¹ Martin Bitzan,² Mohamed A. Karmali,^3, Christoph Bobrowski,⁴ Hans Ruder,^5, Rainer Laufs,⁶ Ingo Sobottka,⁶ Martin Petric,³ Helge Karch,^7, and Dirk E. Müller-Wiefel¹

Klinik und Poliklinik für Kinder- und Jugendmedizin,,¹ Medizinische Kernklinik und Poliklinik,⁴ Institut für Medizinische Mikrobiologie und Immunologie, Universitätsklinikum Hamburg-Eppendorf, Universität Hamburg, 20246 Hamburg,⁶ Klinik mit Poliklinik für Kinder- und Jugendliche der Friedrich-Alexander-Universität Erlangen-Nürnberg, 91504 Erlangen,⁵ Institut für Hygiene und Mikrobiologie der Universität Würzburg, 97080 Würzburg, Germany,⁷ Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina,² Research Institute and Division of Microbiology, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, and Department of Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada M5G 1X8³

Received 17 September 2001/ Returned for modification 3 December 2001/ Accepted 10 February 2002

Ninety-five household contacts (aged 2 months to 73 years) of patients with enteropathic hemolytic-uremic syndrome (HUS) were investigated for the presence of immunoglobulin (Ig) G antibodies to Shiga toxins Stx2 and Stx1 by Western blot assay. Thirty-one percent of the household contacts and 19% of 327 controls had anti-Stx2 IgG (heavy and light chain [H + L]), 5 and 8%, respectively, had anti-Stx1 IgG (H + L), and 3 and 2%, respectively, had both anti-Stx2 and anti-Stx1 IgG (H + L). The incidence of infections with Stx-producing Escherichia coli (STEC) was determined based on the following diagnostic criteria: STEC isolation, detection of stx gene sequences, free fecal Stx in stool filtrates, and serum IgM antibodies against E. coli O157 lipopolysaccharide. Evidence of STEC infection was observed in 25 household contacts, of whom 18 (72%) were asymptomatic and represented a potential source of infection. Six of 13 (46%) household contacts with Stx2-producing E. coli O157:H7 in stool culture developed anti-Stx2 IgG (H + L), compared to 71% of Stx2-associated HUS cases. In individuals showing anti-Stx2 IgG (H + L), the antibody response was directed against the B subunit in 69% of household contacts and 71% of controls, in contrast to 28% of HUS patients. In this investigation controls had a significant increase of the median of IgM antibodies to O157 lipopolysaccharide (LPS) with age, up to the fifth decade. The lack of disease in household contacts with B subunit-specific antibodies, as well as the significantly higher median of anti-O157 LPS IgM antibodies in controls beyond 4.9 years of age, suggests a protective role for anti-Stx and anti-O157 LPS antibodies.

---

* Corresponding author. Mailing address: Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. Phone: 49-40-428032702. Fax: 49-40-428035053. E-mail: kludwig{at}uke.uni-hamburg.de.

Present address: Laboratory for Foodborne Zoonoses, Population and Public Health Branch, Health Canada, Guelph, Ontario, Canada N1G 3W4.

Present address: Caritas Haus Feldberg, 79868 Feldberg, Germany.

Present address: Institut für Hygiene, Universität Münster, 48129 Münster, Germany.

---

Journal of Clinical Microbiology, May 2002, p. 1773-1782, Vol. 40, No. 5
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.5.1773-1782.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

This article has been cited by other articles:

• Dowling, T. C., Chavaillaz, P. A., Young, D. G., Melton-Celsa, A., O'Brien, A., Thuning-Roberson, C., Edelman, R., Tacket, C. O. (2005). Phase 1 Safety and Pharmacokinetic Study of Chimeric Murine-Human Monoclonal Antibody c{alpha}Stx2 Administered Intravenously to Healthy Adult Volunteers. Antimicrob. Agents Chemother. 49: 1808-1812 [Abstract] [Full Text]  
• Matussek, A., Lauber, J., Bergau, A., Hansen, W., Rohde, M., Dittmar, K. E. J., Gunzer, M., Mengel, M., Gatzlaff, P., Hartmann, M., Buer, J., Gunzer, F. (2003). Molecular and functional analysis of Shiga toxin-induced response patterns in human vascular endothelial cells. Blood 102: 1323-1332 [Abstract] [Full Text]