Escherichia coli O157:H7 and the hemolytic uremic syndrome: importance of early cultures in establishing the etiology

J Infect Dis. 1990 Aug;162(2):553-6. doi: 10.1093/infdis/162.2.553.


Fifty-two patients were studied prospectively to determine the etiology of postdiarrheal hemolytic uremic syndrome (HUS). Escherichia coli O157:H7 was isolated from 33 patients (63.4%). If stool obtained within 2 days of the onset of diarrhea was cultured for E. coli O157:H7, the recovery rate was 100%. This rate decreased to 91.7% and 33.3% if stool was cultured for this pathogen 3-6 or greater than or equal to 7 days, respectively, after diarrhea began. The culture-positive group was more likely to have had bloody diarrhea and fecal leukocytes and to have received transfusions than the culture-negative group but was otherwise similar in clinical characteristics. E. coli O157:H7 is the predominant pathogen associated with HUS in western Washington. Recovery of this pathogen is highly dependent on obtaining stool cultures within 6 days of onset of diarrhea.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Colitis / complications
  • Colitis / drug therapy
  • Diarrhea / complications*
  • Diarrhea / microbiology
  • Escherichia coli / isolation & purification*
  • Escherichia coli Infections / complications*
  • Escherichia coli Infections / microbiology
  • Feces / microbiology*
  • Female
  • Gastrointestinal Hemorrhage / complications
  • Gastrointestinal Hemorrhage / drug therapy
  • Hemolytic-Uremic Syndrome / etiology*
  • Hemolytic-Uremic Syndrome / microbiology
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Prospective Studies


  • Anti-Bacterial Agents