{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T07:03:25Z","timestamp":1790233405255,"version":"4.1.0"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2009,10,19]],"date-time":"2009-10-19T00:00:00Z","timestamp":1255910400000},"content-version":"unspecified","delay-in-days":6045,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[1993,4]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>To assess the importance of infection by Verotoxin (VT) producing <jats:italic>Escherichia coli<\/jats:italic> (VTEC) in children with HUS in Central Europe, stool and\/or serum samples obtained from 147 patients from 28 paediatric centres were prospectively examined for the presence of VTEC and the kinetics of faecal VT titres (FVT), and for VT neutralization titres and antibodies against <jats:italic>E. coli<\/jats:italic> O 157 lipopolysaccharide, respectively. Ninety-two percent of the patients had classic (enteropathic) HUS (E<jats:sup>+<\/jats:sup> HUS). Evidence of VTEC infection was obtained in 86% of them. VTEC\/FVT were identified in 55\/118 E<jats:sup>+<\/jats:sup> cases (47%). A prominent feature was the frequent isolation of sorbitol-fermenting, VT2-producing <jats:italic>E. coli<\/jats:italic> O 157. H<jats:sup>\u2212<\/jats:sup>. VT1 (C600\/H19) was neutralized by 9%, and VT2 (C600\/933W) by 99% of the initial serum samples from E<jats:sup>+<\/jats:sup> patients, compared to 3% (VT1) and 100% (VT2) from age-related controls. Fourfold titre rises against VT1 and\/or VT2 were observed in 13\/70 (19%), and significantly elevated O 157 LPS IgM and\/or IgA antibodies in 106\/128 (83%) of the E<jats:sup>+<\/jats:sup> patients. The ubiquitous VT2 neutralizing principle in the serum of HUS patients as of healthy controls warrants further investigations.<\/jats:p>","DOI":"10.1017\/s0950268800068102","type":"journal-article","created":{"date-parts":[[2009,10,19]],"date-time":"2009-10-19T12:39:50Z","timestamp":1255955990000},"page":"183-196","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":96,"title":["The role of <i>Escherichia coli<\/i> O 157 infections in the classical (enteropathic) haemolytic uraemic syndrome: Results of a Central European, multicentre study"],"prefix":"10.1017","volume":"110","author":[{"given":"M.","family":"Bitzan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Ludwig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Klemt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"B\u00fcren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. E.","family":"M\u00fcller-Wiefel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2009,10,19]]},"reference":[{"key":"S0950268800068102_ref041","first-page":"745","volume":"ii","author":"Notenboom","year":"1987","journal-title":"Clinical relevance of a serological cross-reaction between Escherichia coli O 157 and Brucella abortus"},{"key":"S0950268800068102_ref001","first-page":"835","volume":"29","author":"Fong","year":"1982","journal-title":"Hemolytie-uremic syndrome. Current concepts and management"},{"key":"S0950268800068102_ref027","first-page":"221","volume":"276","author":"Aleksic","year":"1992","journal-title":"A Biotyping scheme for Shiga-like (Vero-) toxinproducing Escherichia coli and a list of serological cross-reactions between O 157 and other gram-negative bacteria"},{"key":"S0950268800068102_ref030","first-page":"361","volume":"12","author":"Gentry","year":"1980","journal-title":"Quantitative microtiter cytotoxicity assay for Shigella toxin"},{"key":"S0950268800068102_ref037","first-page":"496","volume":"274","author":"Bitzan","year":"1991","journal-title":"Clinical and genetic aspects of Shiga-like toxin production in traditional enteropathogenic Escherichia coli"},{"key":"S0950268800068102_ref031","first-page":"237","volume":"25","author":"Scotland","year":"1988","journal-title":"Verocytotoxin-producing strains of Escherichia coli from children with haemolytic uraemic syndrome and their detection by specific DNA probes"},{"key":"S0950268800068102_ref036","first-page":"707","volume":"155","author":"Karch","year":"1987","journal-title":"Phage-associated cytotoxin production by and enteroadhesiveness of enteropathogenic Escherichia coli isolated from infants with diarrhea in West Germany"},{"key":"S0950268800068102_ref035","first-page":"869","volume":"23","author":"March","year":"1986","journal-title":"Sorbitol-MacConkey medium for detection of Escherichia coli O 157. H7 associated with hemorrhagic colitis"},{"key":"S0950268800068102_ref009","first-page":"211","volume":"51","author":"Head","year":"1988","journal-title":"Purification and characterization of Verocytotoxin 2"},{"key":"S0950268800068102_ref034","first-page":"620","volume":"22","author":"Farmer","year":"1985","journal-title":"H7 antiserum-sorbitol fermentation medium: a single tube screening medium for detecting Escherichia coli O 157. H7 associated with hemorrhagic colitis"},{"key":"S0950268800068102_ref033","first-page":"1807","volume":"30","author":"Gunzer","year":"1992","journal-title":"Molecular detection of sorbitol fermenting Escherichia coli O 157 in patients with hemolytic-uremic syndrome"},{"key":"S0950268800068102_ref040","first-page":"246","volume":"17","author":"Bitzan","year":"1988","journal-title":"Relevance of verotoxin mediated hemolytic-uremic syndrome in Germany"},{"key":"S0950268800068102_ref024","first-page":"189","volume":"23","author":"Barrett","year":"1991","journal-title":"Enzyme-linked immunosorbent assays for detecting antibodies to Shiga-like toxin I, Shiga-like toxin II, and Escherichia coli O 157. H7 lipopolysaccharide in human serum"},{"key":"S0950268800068102_ref008","first-page":"135","volume":"53","author":"Strockbine","year":"1980","journal-title":"Two toxin-converting phages from Escherichia coli O 157"},{"key":"S0950268800068102_ref010","first-page":"2704","volume":"29","author":"Hii","year":"1991","journal-title":"Development of verotoxin 2- and verotoxin 2 variant (VT2v)-specific oligonucleotide probes on the basis of the nucleotide sequence of the B eistron of VT2v from Escherichia coli E32511 and B2F1"},{"key":"S0950268800068102_ref011","first-page":"1065","volume":"59","author":"Schmitt","year":"1991","journal-title":"Two copies of Shiga-like toxin II-related genes common in enterohemorrhagic Escherichia coli strains are responsible for the antigenic heterogeneity of the O 157. H\u2212 strain E32511"},{"key":"S0950268800068102_ref039","first-page":"276","volume":"4","author":"Kaplan","year":"1990","journal-title":"Recent advances in understanding the pathogenesis of the hemolytic uremic syndromes"},{"key":"S0950268800068102_ref032","first-page":"722","volume":"65","author":"Kleanthous","year":"1990","journal-title":"Haemolytic uraemic syndromes in the British Isles, 1985\u20138: association with Verocytotoxin producing Escherichia coli. Part 2: microbiological aspects"},{"key":"S0950268800068102_ref006","first-page":"775","volume":"151","author":"Karmali","year":"1985","journal-title":"The association between idiopathic hemolytic uremic syndrome and infection by Verotoxin-producing Escherichia coli"},{"key":"S0950268800068102_ref018","first-page":"512","volume":"18","author":"Wells","year":"1983","journal-title":"Laboratory investigation of hemorrhagic colitis outbreaks associated with a rare Escherichia coli serotype"},{"key":"S0950268800068102_ref004","first-page":"716","volume":"65","author":"Milford","year":"1990","journal-title":"Haemolytic uraemic syndromes in the British Isles 1985\u20138: association with Verocytotoxin-producing Escherichia coli. Part 1"},{"key":"S0950268800068102_ref014","first-page":"33","volume":"44","author":"Marques","year":"1987","journal-title":"Escherichia coli strains isolated from pigs with edema disease produce a variant of Shiga-like toxin II"},{"key":"S0950268800068102_ref023","first-page":"138","volume":"337","author":"Chart","year":"1991","journal-title":"Serological identification of Escherichia coli O 157.7 infection in haemolytic uraemic syndrome"},{"key":"S0950268800068102_ref015","first-page":"1180","volume":"27","author":"Karch","year":"1989","journal-title":"Evaluation of oligonucleotide probes for identification of Shiga-liketoxin-producing Escherichia coli"},{"key":"S0950268800068102_ref012","first-page":"611","volume":"58","author":"Samuel","year":"1990","journal-title":"Comparison of the glycolipid receptor specificities of Shiga-like toxin type II and Shiga-like toxin type II variants"},{"key":"S0950268800068102_ref029","first-page":"193","volume":"22","author":"Karch","year":"1984","journal-title":"Analysis of electrophoretically heterogeneous lipopolysaccharides of Escherichia coli by immunoblotting"},{"key":"S0950268800068102_ref003","first-page":"1161","volume":"323","author":"Martin","year":"1990","journal-title":"The epidemiology and clinical aspects of the hemolytic uremie syndrome in Minnesota"},{"key":"S0950268800068102_ref005","first-page":"218","volume":"119","author":"Rowe","year":"1991","journal-title":"Epidemiology of hemolytic-uremic syndrome in Canadian children from 1980\u20131988"},{"key":"S0950268800068102_ref016","first-page":"1339","volume":"29","author":"Tyler","year":"1991","journal-title":"Identification of verotoxin type 2 variant B subunit genes in Escherichia coli by the polymerase chain reaction and restriction fragment length polymorphism analysis"},{"key":"S0950268800068102_ref025","first-page":"380","volume":"119","author":"Bitzan","year":"1991","journal-title":"High incidence of serum antibodies to Escherichia coli O 157 lipopolysaccharide in children with hemolytic uremic syndrome"},{"key":"S0950268800068102_ref017","first-page":"15","volume":"2","author":"Karmali","year":"1989","journal-title":"Infection by verocytotoxin-producing Escherichia coli"},{"key":"S0950268800068102_ref019","first-page":"553","volume":"162","author":"Tarr","year":"1990","journal-title":"Escherichia coli O 157. H7 and the hemolytic uremic syndrome: importance of early cultures in establishing the etiology"},{"key":"S0950268800068102_ref002","first-page":"148","volume":"24","author":"Kaplan","year":"1987","journal-title":"The hemolytic uremic syndrome of childhood and its variants"},{"key":"S0950268800068102_ref022","first-page":"285","volume":"27","author":"Chart","year":"1989","journal-title":"Serum antibodies to Escherichia coli serotype O 157. H7 in patients with hemolytic uremic syndrome"},{"key":"S0950268800068102_ref028","first-page":"83","volume":"5","author":"Westphal","year":"1905","journal-title":"Bacterial lipopolysaccharides: extraction with phenol-water and further applications of the procedure"},{"key":"S0950268800068102_ref013","first-page":"3617","volume":"266","author":"Head","year":"1991","journal-title":"Preparation of VT1 and VT2 hybrid toxins from their purified dissociated subunits. Evidence for B subunit modulation of a subunit function"},{"key":"S0950268800068102_ref038","first-page":"60","volume":"13","author":"Griffin","year":"1991","journal-title":"The epidemiology of infections caused by Escherichia coli O 157. H7, other enterohemorrhagic E. coli, and the associated hemolytic uremic syndrome"},{"key":"S0950268800068102_ref026","first-page":"58","volume-title":"Statistisches Jahrbuch 1988 f\u00fcr die Bundesrepublik Deutschland","year":"1988"},{"key":"S0950268800068102_ref021","first-page":"469","volume":"160","author":"Lopez","year":"1989","journal-title":"Hemolytic uremic syndrome and diarrhea in Argentine children: the role of Shiga-like toxins"},{"key":"S0950268800068102_ref020","first-page":"288","volume":"2","author":"Novillo","year":"1988","journal-title":"Haemolytic-uraemic syndrome associated with faecal cytotoxin and verotoxin neutralizing antibodies"},{"key":"S0950268800068102_ref007","first-page":"206","volume":"51","author":"O'Brien","year":"1987","journal-title":"Shiga and Shiga-like toxins"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268800068102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,15]],"date-time":"2019-05-15T23:35:10Z","timestamp":1557963310000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268800068102\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,4]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1993,4]]}},"alternative-id":["S0950268800068102"],"URL":"https:\/\/doi.org\/10.1017\/s0950268800068102","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,4]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 1993","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}