Typical haemolytic uraemic syndrome (STEC‐HUS), caused by Shiga toxin (Stx)‐producing Escherichia coli (STEC), is a serious, life‐threating disease that mainly affects children. Bacteriological and genetic tests are commonly used in the routine laboratory diagnosis of STEC‐HUS; however, serological methods have emerged as useful and reliable diagnostic tools, especially when bacterial isolation fails. In this study, we present the results of the serological investigation of 72 paediatric patients suspected for HUS, hospitalized during 2011–2019 at the Department of Pediatrics and Nephrology of Children’s Hospitals in Poland. During the routine laboratory investigation STEC strains were isolated only from nine stool samples. However, serological investigations confirmed 45 cases of STEC infections in children with HUS. In this study, 22 (48·9%) paediatric patients were infected by E. coli serotype O26, 11 (24·4%) by serotype O145, 9 (20·0%) by serotype O157, and 3 (6·7%) by E. coli serotype O111. In the majority of these patients, in addition to a high level of IgA, IgG and IgM antibodies to lipopolysaccharide of particular E. coli serotypes, antibodies to recombinant proteins Tir, Stx2b and intimin were detected. Our results confirm that serological tests are useful in the diagnosis of STEC‐HUS.

中文翻译：

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波兰溶血性尿毒症综合征患儿对产志贺毒素 (Stx) 大肠杆菌 (STEC) 脂多糖和重组蛋白的抗体反应

由产志贺毒素 (Stx) 的大肠杆菌 (STEC) 引起的典型溶血性尿毒症综合征 (STEC-HUS) 是一种严重的危及生命的疾病，主要影响儿童。细菌学和基因检测常用于 STEC-HUS 的常规实验室诊断；然而，血清学方法已成为有用且可靠的诊断工具，尤其是在细菌分离失败时。在本研究中，我们展示了对 2011-2019 年在波兰儿童医院儿科和肾脏科住院的 72 名疑似 HUS 儿科患者的血清学调查结果。在常规实验室调查期间，仅从九个粪便样本中分离出了 STEC 菌株。然而，血清学调查证实了 45 例 HUS 儿童的 STEC 感染病例。在这项研究中，22 名 (48·9%) 儿科患者感染了 O26 型大肠杆菌，11 名 (24·4%) 名被 O145 型感染，9 名 (20·0%) 名被 O157 感染，3 名 (6·7%) 名被 E . 大肠杆菌血清型 O111。在大多数这些患者中，除了高水平的针对特定大肠杆菌血清型脂多糖的 IgA、IgG 和 IgM 抗体外，还检测到针对重组蛋白 Tir、Stx2b 和内联蛋白的抗体。我们的结果证实血清学检测可用于 STEC-HUS 的诊断。