Case-management protocol for bloody diarrhea as a model to reduce the clinical impact of Shiga toxin-producing Escherichia coli infections. Experience from Southern Italy

• DOI: 10.1007/s10096-019-03755-0
• Publication Date: 2019-11-27T16:02:51Z
• Authors: Daniela Loconsole; Mario Giordano; Nicola Laforgia; Diletta Torres; Luisa Santangelo; Vincenza Carbone; Antonio Parisi; Michele Quarto; Gaia Scavia; Maria Chironna
• Keywords: Bloody diarrhea; Medical microbiology; STX2

To describe an operating protocol for bloody diarrhea (BD) in a pediatric population as rapid response to public health threat represented by excess of HUS cases the Apulia region (Southern Italy) starting from 2013. The was set up with goal correct clinical management Shiga toxin-producing Escherichia coli (STEC) infections, reductions subsequent hemolytic uremic syndrome (HUS), and improved short- long-term disease outcomes. consisted hospitalization children (BD), hematochemical laboratory tests every 12-24 hours, prompt diagnosis STEC. No antibiotics were recommended until diagnosis. Children positive STEC infections underwent early vigorous volume expansion. In June-December 2018, 438 BD hospitalized, which 53 (12.1%) had infection. most common serogroups O26 (36.1%), O111 (23.0%), O157 (14.8%). Thirty-one samples carried stx2 gene. Four evolved into (7.5%), all favorable outcome despite neurological involvement two cases. Prompt accurate is utmost importance patients management. strict adherence could reduce progression rate prevents complications. Enhanced surveillance may help Southern Italy.