Enterohemorrhagic E. coli and hemolytic uremic syndrome in Georgia.

It is important to consider that between Jul-October 2009 in the pathologic center of infectious diseases (Tbilisi State Medical University Department of Infectious Diseases) among hospitalized patients with hemorrhagic colitis 25 patients developed HUS syndrome. Most of patients were rural residents 20 (80%), only 5 (20%) were urban. 11 (44%) patients were children, 14 (56%) were adults. Male and female rate was equal. All the patients related the onset of the disease with the consumption of notwashed raw fruits or vegetables, nonpasteurized dairy products, food from street vendors, soft cheeses made from raw milk and untreated water in areas lacking adequate chlorination. The onset of the disease was not acute: low grade fever (37,5-37,8(0)C), severe diffuse pain in abdomen accompanied with cramps, frequent bowel movement with loose, watery stools 5-6 times a day. On the 2-3rd days of disease condition was worsened by increased of intoxication and frequent bowel movement with bloody stools about 10-15-20 times a day. On the 3-4 rd days of the onset of the diarrhea developed oliguria, anuria, edema. Among other complications important were: polyserosit - 8 (32%), encephalopathy - 2 (8%), disseminated intravascular coagulation - 3 (14%), ileus -1 (4%,) acute reactive phsycosis - 1 (4)%. In 15 (60%) cases became necessary to carry out hemodialysis. died 5 patients, lethality is - 5 (20%). Treatment options included: pathogenetic and symptomatic. Thus, increased rate of patients in the recent years indicates to circulation of shiga-toxin producing E.Coli in Georgia.