Shiga Toxin producing E. coli (STEC) Infection Study
Dr. David Schnadower is the PI at CCHMC on This NIH funded, multisite study of the treatment of STEC is led at Cincinnati Children’s by Dr. David Schnadower. This study will evaluate hyperhydration v. hydration maintenance in preventing these outcomes. Contact McKayla Schloemer at 513-803-9134 or email Mckayla.schloemer@cchmc.org with any questions about the study.
A reference guide has been developed for providers to assist with assessment and treatment.
Shiga Toxin producing E. coli (STEC) infections are an important cause of morbidity and mortality amongst children presenting with acute bloody diarrhea. The most serious complication of STEC infections is Hemolytic Uremic Syndrome (HUS), characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury (AKI). Fifteen to 20% of children with STEC will develop HUS 3-10 days after the onset of diarrhea. Of the children that develop HUS, 60% will require dialysis and up to 2% may die. Early identification, hydration, and close follow up are essential to prevent or minimize complications. All children with grossly bloody diarrhea presumed to be infectious or non-bloody diarrhea with a STEC risk factor should have a molecular routine bacterial stool pathogens test sent immediately. A CBC and BMP will help determine if there is HUS. Given the high likelihood of complications, children with confirmed STEC infection should ideally be referred to Cincinnati Children’s Emergency Department. Preliminary studies show early IV fluid administration may mitigate or prevent complications, including HUS and need for dialysis.