Shiga Toxin–ProducingEscherichia coliInfections Associated with Hemolytic Uremic Syndrome, Italy, 1988–2000

The mean annual incidence of hemolytic uremic syndrome in persons <15 years of age in Italy from 1988 to 2000 was 0.28 per 100,000 population. Laboratory investigations showed that Shiga toxin-producing Escherichia coli (STEC) infection occurred in 73.1% of patients. STEC O157 was the most common serotype, but a considerable number of cases were from infections by non-O157 STEC. emolytic uremic syndrome (HUS) is the most severe and specific clinical manifestation of infections with Shiga toxin (Stx)-producing Escherichia coli (STEC), especially E. coli O157:H7 and other enterohemorrhagic serotypes; the incidence of HUS represents a robust index of the total incidence of these infections in a population (1). In Italy, HUS notification is not yet mandatory, but a nationwide surveillance system was established in 1988 and has been followed on a voluntary basis with the collaboration of the Italian Society for Pediatric Nephrology. Since then, the HUS surveillance system has been maintained to monitor the incidence of the disease, describe those affected, identify the STEC serotypes associated with HUS, and investigate possible risk factors associated with STEC infection.