Blood group and susceptibility to disease caused by Escherichia coli O157

Patients (n = 186) infected during the Escherichia coli O157 outbreak in Scotland in 1996 were assessed for blood group markers (ABO, Lewis, and P) associated with other gastrointestinal infections. Binding of bacteria to epithelial cells was assessed by flow cytometry. Buffy coats from blood donors were examined for inflammatory responses to culture filtrates of the outbreak strain. Individuals of blood group O comprised 63.4% of patients, compared with 53.4% (P < .05) and 53.9% (P < .01) of neighboring populations in Airdrie and Glasgow, respectively; group O also comprised 64.3% of patients with hemolytic uremic syndrome (HUS) and 87.5% of patients who died (P < .05). No or weak agglutination by anti-P antiserum was observed for 40.7% of control persons (n = 122), 61.5% of all patients (P = .0027), and 83.3% of patients with HUS (P = .013). The susceptibility of group O to E. coli was not associated with increased binding of bacteria to epithelial cells or with higher production of tumor necrosis factor (TNF)-α or interleukin-6. Leukocytes of P-negative blood donors produced higher levels of TNF-α than those of P-positive donors.