Short summary

Shiga toxin-producing Escherichia coli (STEC) is a notorious foodborne bacterium that can cause bloody diarrhea, kidney failure and death. There is a lack on STEC studies in whole populations owing to the fact that diagnosis of STEC is expensive and time-consuming. Consequently, STEC screening of stool samples is normally confined to selected patients and STEC types. Department of Clinical Microbiology at Odense University Hospital and Sygehus Lillebælt Vejle has since the year 2011 and 2013 respectively, investigated all stool samples for the presence of all known STEC types. These unique data allows concise population based reports on incidence, virulence and clinical associations.   

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Rationale

Since the 1980's, STEC of the type O157 has been known as one of the most dangerous foodborne infections. The bacterium has an unusual potential to affect children where it causes bloody diarrhea and inflict organ damage as part of the hemolytic uremic syndrome (HUS). This means that 10 - 15% develop HUS with a subsequent risk of end stage kidney disease and death. Other types of STEC called Non-O157 are more clinically diverse and not as well described in literature as the O157 type. This has led to discussions in leading scientific journals about pathogenic potential and incidence. From 2000 - 2012 the incidence of STEC in Denmark has tripled. Outbreaks of STEC strains possess a significant threat to public health. Recent decades has displayed the challenges faced by modern health care systems as hyper virulent STEC strains cross time and boarders. In a time with increased travel activity and international trade of goods and food, the risk of STEC transmission is on the rise.

Department of Clinical Microbiology carry out both diagnostics and clinical counselling of STEC infections. From this position, successive registration of microbiological and clinical characteristics has conferred insight on new associations and dynamics. This has raised the hypothesis that STEC type O157 is a cause of acute bloody diarrhea with hospitalization while STEC of the type Non-O157 is a cause of chronic diarrhea and abdominal discomfort. The departments of Clinical Microbiology in Odense and Vejle investigate as the only departments in Denmark all admitted stool samples for the presence of STEC. This unique unselected material has provided an opportunity to conduct this project where we compare bacterial and clinical characteristics in a whole population. In order to report the most reliable and detailed data till date the project is established in cooperation between the locale departments, the WHO Collaborating Centre for Reference and Research on Escherichia and Klebsiella, SSI, and OPEN Odense Patient data Explorative Network. 

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Description of the cohort

226 patients of all age and gender that are diagnosed with STEC between the years 2011 - 2014 are included in this historical cohort.  

Data and biological material

Demographic data:
Is collected from Statistics Denmark and the laboratory data system. 

Microbiological data:
Is collected from the laboratory data system and the national intestinal bacterial database.  

Clinical data:
Is collected from medical records and the laboratory data system.

Collaborating researchers and departments

Department of Clinical Microbiology, Odense University Hospital

• PhD-student and Specialist Registrar Rune Micha Pedersen, MD
• Consultant Flemming Schønning Rosenvinge, MD
• Consultant Hanne Marie Holt, PhD, MD
• House Officer Marc Trunjer Kusk Nielsen, MD

Statens Serum Institut, WHO Collaborating Centre for Reference and Research on Escherichia and Klebsiella

• Head of Department Flemming Scheutz, MSc, PhD

OPEN Odense Patient data Explorative Network, Odense University Hospital

• Assistant Professor Sören Möller, MSc, PhD