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. 2023 Oct;29(10):2054-2064.
doi: 10.3201/eid2910.230382.

Sporadic Shiga Toxin-Producing Escherichia coli-Associated Pediatric Hemolytic Uremic Syndrome, France, 2012-2021

Gabrielle Jones, Patricia Mariani-Kurkdjian, Aurélie Cointe, Stéphane Bonacorsi, Sophie Lefèvre, François-Xavier Weill, Yann Le Strat

Sporadic Shiga Toxin-Producing Escherichia coli-Associated Pediatric Hemolytic Uremic Syndrome, France, 2012-2021

Gabrielle Jones et al. Emerg Infect Dis. 2023 Oct.

Abstract

Shiga toxin-producing Escherichia coli-associated pediatric hemolytic uremic syndrome (STEC-HUS) remains an important public health risk in France. Cases are primarily sporadic, and geographic heterogeneity has been observed in crude incidence rates. We conducted a retrospective study of 1,255 sporadic pediatric STEC-HUS cases reported during 2012-2021 to describe spatiotemporal dynamics and geographic patterns of higher STEC-HUS risk. Annual case notifications ranged from 109 to 163. Most cases (n = 780 [62%]) were in children <3 years of age. STEC serogroups O26, O80, and O157 accounted for 78% (559/717) of cases with serogroup data. We identified 13 significant space-time clusters and 3 major geographic zones of interest; areas of southeastern France were included in >5 annual space-time clusters. The results of this study have numerous implications for outbreak detection and investigation and research perspectives to improve knowledge of environmental risk factors associated with geographic disparities in STEC-HUS in France.

Keywords: Escherichia coli; France; STEC; Shiga toxin–producing Escherichia coli; bacteria; bacterial infections; epidemiologic surveillance; food safety; hemolytic uremic syndrome; space-time clustering.

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Figures

Figure 1
Figure 1
Annual reported number of sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases, France, 2012–2021. A) All cases; B) cases of infection with serogroups O26, O80, and O157.
Figure 2
Figure 2
Age-standardized annual incidence rates of reported sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases, for all cases and cases of infection with serogroups O26, O80, and O157, France, 2012–2021.
Figure 3
Figure 3
Number of reported sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases, by age group and sex, and incidence rate, by age group (black dots), France, 2012–2021. Data were missing on sex for 3 cases (1 case each in patients <1 year, 3 years, and 4 years of age).
Figure 4
Figure 4
Monthly age-standardized incidence rates of reported sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases, France, 2012–2021.
Figure 5
Figure 5
Geographic distribution of age-standardized incidence rates of all reported sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases, France, 2012–2021. A) 2012; B) 2013; C) 2014; D) 2015; E) 2016; F) 2017; G) 2018; H) 2019; I) 2020; J) 2021.
Figure 6
Figure 6
Geographic distribution of age-standardized incidence rates of reported sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases caused by serogroups O26, O80, and O157, France, 2012–2021. A–C) Serogroups O26 (A), O80 (B), and O157 (C) during 2012–2016. D–F) Serogroups O26 (D), O80 (E), and O157 (F) during 2017–2021.
Figure 7
Figure 7
Significant clusters detected by space–time scanning of all reported sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases, France, 2012–2021.
Figure 8
Figure 8
Significant clusters detected by annual space–time scanning of all reported sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases, France, 2012–2021. A) 2012; B) 2013; C) 2015; D) 2016; E) 2018; F) 2019; G) 2020; H) 2021; I) 2012–2021.
Figure 9
Figure 9
Cluster recurrence index of all reported sporadic Shiga toxin–producing Escherichia coli–associated pediatric hemolytic uremic syndrome cases, France, 2012–2021.
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References

    1. Joseph A, Cointe A, Mariani Kurkdjian P, Rafat C, Hertig A. Shiga toxin–associated hemolytic uremic syndrome: a narrative review. Toxins (Basel). 2020;12:67. 10.3390/toxins12020067 - DOI - PMC - PubMed
    1. Majowicz SE, Scallan E, Jones-Bitton A, Sargeant JM, Stapleton J, Angulo FJ, et al. Global incidence of human Shiga toxin-producing Escherichia coli infections and deaths: a systematic review and knowledge synthesis. Foodborne Pathog Dis. 2014;11:447–55. 10.1089/fpd.2013.1704 - DOI - PMC - PubMed
    1. European Centre for Disease Prevention and Control. STEC infection: annual epidemiological report for 2021. 2022. [cited 2023 Jan 15]. https://www.ecdc.europa.eu/sites/default/files/documents/AER%20STEC%20-%...
    1. Bruyand M, Mariani-Kurkdjian P, Le Hello S, King LA, Van Cauteren D, Lefevre S, et al. ; Réseau français hospitalier de surveillance du SHU pédiatrique. Paediatric haemolytic uraemic syndrome related to Shiga toxin-producing Escherichia coli, an overview of 10 years of surveillance in France, 2007 to 2016. Euro Surveill. 2019;24:1800068. 10.2807/1560-7917.ES.2019.24.8.1800068 - DOI - PMC - PubMed
    1. Jones G, Mariani-Kurkdjian P, Cointe A, Bonacorsi S, Lefèvre S, Pardos de la Gandara M, et al. Annual report for surveillance of hemolytic uremic syndrome in children under 15 years old, France 2021 [in French]. 2022. [cited 2022 Dec 1]. https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-inf...

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