PDF(Pubmed)
Abstract：
BackgroundHaemolytic uremic syndrome (HUS) is a severe complication of infection with Shiga toxin-producing Escherichia coli (STEC). Although the reservoirs of STEC are known, the source of the infection of sporadic cases is often unknown. In 2023, we observed several cases of bloody diarrhoea with STEC infection in children and adolescents returning from vacations.AimWe aimed to explore the association between travel and bloody diarrhoea with STEC infection in children and adolescents.MethodsWe included all children and adolescents with bloody diarrhoea with STEC infection identified in 2023 by the ItalKid-HUS Network surveillance system in northern Italy. We interviewed children\'s families and sent a questionnaire on recent travels abroad. The exposure time was between 3 days after arrival abroad and 5 days after return home. A self-controlled case series (SCCS) design was used in the analysis.ResultsOf the 43 cases, 11 developed HUS. Twenty-three cases did not travel abroad, while 20 had travelled to several destinations. The incidence rate ratio (IRR) associated with travel to Egypt was 88.6 (95% confidence interval (CI): 17.0-462). Serotype analysis excluded the possibility of a single strain causing the infections. We did not find the source of the infections.ConclusionThere is an elevated risk of acquiring STEC infection with bloody diarrhoea and HUS associated with travel to Egypt. Specific investigations to identify the source are needed to implement effective preventive measures.
摘要：
背景溶血性尿毒综合征（HUS）是产志贺毒素大肠杆菌（STEC）感染的严重并发症。尽管STEC的水库是已知的，散发性病例的感染源往往是未知的。在2023年，我们观察到从假期返回的儿童和青少年中出现了几例带有STEC感染的血性腹泻病例。目的我们旨在探讨儿童和青少年旅行和血性腹泻与STEC感染之间的关系。方法我们纳入了意大利北部ItalKid-HUS网络监测系统于2023年确定的所有患有血腥腹泻并感染STEC的儿童和青少年。我们采访了儿童的家庭，并发送了一份关于最近出国旅行的问卷。暴露时间在到达国外后3天至回国后5天之间。在分析中使用了自控案例系列(SCCS)设计。结果43例,11开发了HUS。二十三宗个案没有前往国外,而20人曾前往几个目的地。与前往埃及旅行相关的发生率比率（IRR）为88.6（95％置信区间（CI）：17.0-462）。血清型分析排除了单一菌株引起感染的可能性。我们没有找到感染源。结论与前往埃及旅行相关的血性腹泻和HUS感染STEC的风险增加。需要进行具体调查以确定来源，以实施有效的预防措施。
