Pediatric Escherichia Coli Infections Follow-up

Updated: Oct 07, 2015
  • Author: Archana Chatterjee, MD, PhD; Chief Editor: Russell W Steele, MD  more...
  • Print
Follow-up

Further Outpatient Care

See the list below:

  • Monitor patients with Escherichia coli infection for postinfectious functional GI disorders such as irritable bowel syndrome. [35]
Next:

Further Inpatient Care

See the list below:

  • Admit for fluid resuscitation and intravenous antibiotic administration any child who is significantly dehydrated, is persistently vomiting, or who has evidence of pyelonephritis.
  • Children with suspected or confirmed sepsis, meningitis, or hemolytic-uremic syndrome (HUS) require skilled inpatient management. HUS may progress to renal failure, which requires meticulous fluid electrolyte management and may require dialysis.
Previous
Next:

Transfer

See the list below:

  • Arrange transfer to a tertiary care facility if HUS is suspected. These patients may require dialysis and should be managed by a team that includes a pediatric intensivist, nephrologist, and infectious disease specialist.
Previous
Next:

Deterrence/Prevention

See the list below:

  • Traveler's diarrhea
    • Drink only carbonated beverages and boiled or bottled water (preferably carbonated). Consider bringing supply of bottled water or premixed infant formula.
    • Travelers should avoid ice, raw salads, and any fruits they do not peel themselves. Consume foods while they are steaming hot.
    • Prophylactic antibiotic treatment is not recommended for infants and children. Parents should carry packets of oral rehydration salts when traveling outside the United States.
    • Promising data have been reported in a patch vaccine containing heat-labile toxin from E coli. [36, 37]
  • Thoroughly cooking ground beef is the most effective measure to prevent hemorrhagic colitis caused by E coli 0157:H7.
  • Although an National Institutes of Health (NIH) investigational vaccine for E coli O157:H7 has been found to be immunogenic in young children, sporadic outbreaks could limit its use on a broad scale. [38] Priority has been placed on vaccination strategies to reduce the carriage of these organisms in the principal reservoir of this pathogen (ie, cattle). [22]
Previous
Next:

Patient Education

See the list below:

  • Advise parents of children diagnosed with hemorrhagic colitis to observe their child closely for signs of HUS (eg, oliguria or anuria, pallor, irritability).
  • Make parents of children diagnosed with urinary tract infection (UTI) aware of the possibility that UTI may be the cause of future episodes of fever, particularly fever without apparent source. Parents should be reminded to inform treating physicians of the child's history of UTI and to discuss indications for obtaining a urine culture.
Previous