Serological investigations on patients with hemolytic uremic syndromes due to enterohemorrhagic Escherichia coli O157:H7 infection

OBJECTIVE: To investigate the etiological agent of patients with diarrhea followed by acute kidney failure symptoms in China, 1999. METHODS: Western blot was used to detect serum specific antibodies of patients against entero-haemorrhagic Escherichia coli hemolysin (EHEC-Hly) and lipo-polysaccharide of E. coli O157. RESULTS: Twenty-one and 16 of 42 patients showed positive reaction of specific IgG or IgM antibodies against EHEC-Hly respectively. Eleven of 42 serum samples were positive for having both IgG and IgM antibodies while 26 of 42 samples were positive for IgG or IgM. For E. coli O157 LPS test, 24 and 24 of 42 samples showed positive for IgG or IgM antibodies respectively. In 42 samples, 20 were positive for IgG and IgM while 29 were positive for IgG or IgM. CONCLUSIONS: Twenty-two of 42 samples were reacted with EHEC-Hly and E. coli O157 LPS, but 34 of 42 samples were positive for EHEC-Hly or E. coli O157. In combination of western blot results, bacterial isolation clinical symptoms and epidemiological investigation findings, it was reasonable to conclude that this cluster of patients with distinguish clinical symptoms was caused by E. coli O157:H7, which had never been reported in China. Hence serological methods with EHEC-Hly and E. coli O157 LPS are valuable for diagnosis of infections of E. coli O157:H7, when bacterial isolation is failed.