Increase in cases of S. pneumoniae associated hemolytic uremic syndrome

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Waters et al report an increased number of cases of S. pneumoniae-associated hemolytic uremic syndrome (P-HUS) in the United Kingdom in recent years. Predominantly associated with invasive pneumococcal disease, it is not clear whether increase in HUS is related to particular serotypes or to bacterial virulence factors or to high bacterial density or persistent infection, or to other factors such as antimicrobial or anti-inflammatory therapies. Because serotypes of S. pneumoniae identified in the P-HUS cases in the U.K. are mainly not included in the heptavalent pneumococcal conjugate vaccine (PCV7), it is important to have these data prior to introduction of PCV7 and to monitor incidence and serotypes related to HUS in the PCV7 era.

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