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Research Letter
June 2014

Prevention of Hemolytic Uremic Syndrome With Daily Bowel Lavage in Patients With Shiga Toxin–Producing Enterohemorrhagic Escherichia coli O104:H4 Infection

Author Affiliations
  • 1Department of Medicine I, University Hospital Hamburg-Eppendorf, Hamburg, Germany
  • 2Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Hamburg, Germany
JAMA Intern Med. 2014;174(6):1003-1005. doi:10.1001/jamainternmed.2014.1175

Infection with Shiga toxin–producing enterohemorrhagic Escherichia coli (EHEC) can cause hemorrhagic colitis and hemolytic uremic syndrome (HUS).1 An epidemic outbreak of EHEC O104:H4 started in May 2011 in northern Germany, affecting 3842 patients and causing 855 cases of HUS.2 There is little evidence in the literature that HUS can be effectively prevented. In this case-series, we present our experience of daily intestinal lavage with polyethylene glycol (PEG) for prevention of HUS in an at-risk group of patients with EHEC.

Between May 13 and June 6, 2011, 33 patients with bloody diarrhea and proven EHEC O104:H4 infection diagnosed via stool cultures were considered to be at risk for HUS development and were subsequently admitted to the First Department of Medicine of the University Medical Center Hamburg-Eppendorf, Hamburg Germany. Institutional review board approval was obtained from the Ethics Committee of the Hamburg Chamber of Physicians, and we conducted a retrospective study.