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Article Dans Une Revue Toxins Année : 2020

Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review

Résumé

The severity of human infection by one of the many Shiga toxin-producing Escherichia coli (STEC) is determined by a number of factors: the bacterial genome, the capacity of human societies to prevent foodborne epidemics, the medical condition of infected patients (in particular their hydration status, often compromised by severe diarrhea), and by our capacity to devise new therapeutic approaches, most specifically to combat the bacterial virulence factors, as opposed to our current strategies that essentially aim to palliate organ deficiencies. The last major outbreak in 2011 in Germany, which killed more than 50 people in Europe, was evidence that an effective treatment was still lacking. Herein, we review the current knowledge of STEC virulence, how societies organize the prevention of human disease, and how physicians treat (and, hopefully, will treat) its potentially fatal complications. In particular, we focus on STEC-induced hemolytic and uremic syndrome (HUS), where the intrusion of toxins inside endothelial cells results in massive cell death, activation of the coagulation within capillaries, and eventually organ failure. Key Contribution: We review here the current understanding of the mechanisms of virulence of Shiga toxin-producing Escherichia coli; in particular how infection can lead to thrombotic microangiopathy and acute kidney injury. A modern procedure for differential diagnosis is also provided.
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Dates et versions

hal-02486805 , version 1 (21-02-2020)

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Adrien Joseph, Aurélie Cointe, Patricia Mariani Kurkdjian, Cédric Rafat, Alexandre Hertig. Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review. Toxins, 2020, 12 (2), pp.67. ⟨10.3390/toxins12020067⟩. ⟨hal-02486805⟩
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