Putative genetic and epidemiological factors associated with development of hemolytic uremic syndrome among verotoxigenic Escherichia coli notifications in Ireland 2017- 2020: a case-control study

Verotoxigenic E. coli (VTEC) infection can cause potentially fatalhemolytic uremic syndrome (HUS). To further our knowledge on theepidemiological and bacterial genomic factors associated with HUS, wecarried out a retrospective case-control study with 108 HUS cases and416 unmatched controls (non-HUS) selected among VTEC notifications inIreland (2017-2020). Routinely collected epidemiological data on VTECnotifications were combined with genome-wide association study(GWAS) findings. Logistic regression was used to estimate adjusted oddsratios (aOR).Our findings reaffirmed known risk factors [young age (0-9 years),presence of specific vtx genes/gene combinations (vtx2a; vtx1a + vtx2a;vtx1a + vtx2c)], and additionally suggest that having outbreakassociatedinfection, residence within the East region of Ireland, and thecombined presence of both ygiW and group_5720 or both pfkA and fieFgenes are potentially associated with developing HUS. Further researchis needed to clarify the functional role of these genes in HUS pathogenesis.