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Volume 31, Number 4—April 2025
Research

Case–Control Study of Factors Associated with Hemolytic Uremic Syndrome among Shiga Toxin–Producing Escherichia coli Patients, Ireland, 2017–2020

Diana Espadinha1Comments to Author , Melissa Brady1Comments to Author , Carina Brehony, Douglas Hamilton, Lois O’Connor, Robert Cunney, Suzanne Cotter, Anne Carroll, Patricia Garvey, and Eleanor McNamara
Author affiliation: European Programme for Public Health Microbiology Training, European Centre for Disease Prevention and Control, Solna, Sweden (D. Espadinha); National Reference Laboratory for STEC at Public Health Laboratory Health Service Executive, Cherry Orchard Hospital, Dublin, Ireland (D. Espadinha, A. Carroll, E. McNamara); European Programme for Intervention Epidemiology Training, European Centre for Disease Prevention and Control, Solna (M. Brady); Health Service Executive Health Protection Surveillance Centre, Dublin (M. Brady, C. Brehony, S. Cotter, P. Garvey); Health Service Executive National Social Inclusion Office, Dublin (D. Hamilton); Health Service Executive Public Health, Dr. Steevens’ Hospital, Dublin (L. O'Connor); Children's Health Ireland at Temple Street, Dublin (R. Cunney); Royal College of Surgeons in Ireland, Dublin (R. Cunney); Trinity College Dublin School of Medicine and Saint James's Hospital, Dublin (E. McNamara)

Main Article

Table 6

Univariate and multivariable analysis of epidemiologic and microbial genomic factors associated with HUS development among persons with STEC in Ireland, 2017–2020*

Category
Unadjusted OR (95% CI)
p value†
Adjusted OR (95% CI)
p value†
Home in rural location
N Referent NI
Y
0.6 (0.3–1.1)
0.075

Reported vomiting
N Referent NI
Y
7.5 (4.6–13)
<0.05

Reported bloody diarrhea
N Referent NI
Y
1.8 (1.2–2.9)
<0.05

Outbreak associated
N Referent
Y
4 (2.5–6.6)
<0.05
3.55 (1.8–7.2)
<0.05
Traveled abroad within past 10 d
N Referent NI
Y
1.1 (0.4–2.3)
0.889

Home drinking water
Public Referent NI
Private well 1 (0.6–1.6) 0.955
Group scheme, public supply 0.9 (0.4–2.2) 0.893
Group scheme, private
0.9 (0.2–2.8)
0.831

Consumed unpasteurized cheese or milk
N Referent NI
Y
1.2 (0.3–3.6)
0.715

Risk group
Not in a risk group Referent NI
Child in crèche 2.3 (1.43.9) <0.05
Attends other institution 2.9 (0.9–9.1) 0.066
Childcare worker 0.3 (0–1.7) 0.297
Food handler
0.6 (0–3.3)
0.62

Recent outdoor recreational activities or recreational farmland contact‡
N Referent NI
Y
1.7 (12.9)
<0.05

Contact with farm animals or their feces
No contact Referent NI
Regular contact§ 1 (0.5–1.3) 0.384
One-off, e.g., visit to a pet farm 1.5 (0.6–3.4) 0.317
Regular and one-off contact 1 (0.2–3.4) 0.979
Contact of unknown nature 7.5 (1.4–54.8) <0.05

*N = 524 patients. Bold indicates significance. HUS, hemolytic uremic syndrome; NI, not included in final model; OR, odds ratio; STEC, Shiga toxin–producing Escherichia coli. †By χ2 test. ‡Hillwalking, camping, swimming in lakes, water sports, beach. §Lives, works, or is cared for on a farm, or exposure to livestock, manure, slurry, or sewage through household contacts.

Main Article

1These authors were co–principal investigators, contributed equally to this work, and share first authorship.

Page created: February 28, 2025
Page updated: March 11, 2025
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