HUS is a common cause of acute renal failure in children. The Registry of HUS, established in 1988 by the Italian Society for Pediatric Nephrology in cooperation with the National Reference Laboratory for E.coli, allows monitoring of HUS and the associated Shigatoxin-producing E.coli (STEC) infections in Italy, and promote clinical studies and research.
Nation-wide reporting of cases is carried out by nephrology units via a dedicated web platform (www.iss.it/seu). Clinical, epidemiological and diagnostic information are collected. In cooperation with three reference laboratories (Istituto Superiore di Sanità, IRCCS Mario Negri and University of Bologna), patients’ biological specimens are submitted for diagnosis of STEC infection host genetic factors investigations. . Collaboration with competent authorities at local, national and European level allows a prompt public health reaction in case of suspect outbreak.
So far, 1,015 cases have been identified with an increasing trend over years. In the last five years, the mean annual incidence (0-15 years) was 0.61 cases x10-5. The median age was 26 months and 775 cases reported prodromal diarrhea. STEC infection was diagnoses in 605 cases (73% of cases with samples submitted). STEC serogroups most frequently involved were by far O26 and O157, followed by 17 other serogroups. Severe epidemic outbreaks, involving up to 23 cases, were revealed by HUS cases, including the recent community-wide national and multinational foodborne outbreaks. Atypical HUS cases for whom neither prodromal diarrhea nor diagnosis of STEC infection was reported, were 57 (7,5% of the cases with information).
The registry data indicate a high burden of HUS in the Italian pediatric population, and highlight the need for a comprehensive, collaborative approach to the clinical, diagnostic and control approach to HUS.In this respect, monitoring has been recently extended to HUS in adults.
