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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 7

Univariate and multivariable analysis of 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†
stx genes
stx1a alone Referent
stx1a + stx2a 9.2 (3.5–31.3) <0.05 36.75 (7.4–358.4) <0.05
stx1a + stx2c 3 (0.6–14.6) 0.164 31.37 (2.9–447.4) <0.05
stx2a alone 16 (6.3–54.6) <0.05 154 (27.2–1,567) <0.05
stx2c alone 3.6 (0.2–29) 0.279 9.88 (0.3–206.5) 0.139
Other stx1 and stx2 combinations
 0.3 (0–2.2)
 0.312
 2.78 (0.1–58.5)
 0.507
eae genes
N NI
Y
 5.3 (2–13.9)
 <0.05
eae subtype
None Referent
β1 4.3 (2–11.6) <0.05 0.4 (0.1–2.8) 0.345
γ1 7.2 (3–19.5) <0.05 0.25 (0–1.4) 0.097
ε1 3.5 (1–13.4) 0.072 1.47 (0.1–18) 0.755
ζ3 3.1 (1–13) 0.136 5.82 (0.2–109.2) 0.244
θ 6.6 (1–27.4) <0.05 1.43 (0.1–14.5) 0.764
κ 0 (NC–4.80 x 1042) 0.098 NI
ξ
 8.3 (0–99.4)
 0.103
 0.57 (0–26.3)
 0.795
ehxA
N Referent
Y
 1 (1–6.4)
 0.113
 0.39 (0.1–1.8)
 0.215
pfkA/fieF
Neither pfkA nor fieF Referent
Both pfkA and fieF
 2 (1–3.1)
 <0.05
 1.82 (1–3.4)
 0.052
ygiW_2/group 5720
Neither ygiW_2 nor group_5720 Referent
Both ygiW_2 and group_5720 3.9 (2.2–7.6) <0.05 5.49 (1.9–18.6) <0.05
Group_5720 only 2 (0.1–13.5) 0.55 2.92 (0.1–44.9) 0.471
ygiW_2 only
 1.6 (0.7–3.7)
 0.238
 2.58 (0.8–9.3)
 0.134
Serogroup
O26 3.1 (1.6–6.6) <0.05 NI
O157 3.5 (1.7–7.7) <0.05
O145 11.1 (4.4–29) <0.05
O103 3.3 (0.9–10.2) <0.05
O55 14.2 (3.7–57) <0.05
O111 11.8 (2–71) <0.05
Other O group Referent

*N = 524 patients. Bold indicates significance. HUS, hemolytic uremic syndrome; NC, not calculable; NI, not included in final model; OR, odds ratio; STEC, Shiga toxin–producing Escherichia coli. †By χ2 test.

Main Article

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

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