Screening criteria
STEC, infections, STEC infection
INFECTIONS, DISEASE COURSE
Participating sites will establish a systematic process to identify all children with high-risk STEC infections within their institution’s catchment area. The process varies by site but includes the creation of electronic dashboards that identify all stool specimens that are positive for an STEC pathogen and the screening of all admission and discharge diagnoses. In addition, as many sites serve as referral institutions, any patient identified as likely having a high-risk STEC infection (defined below) within 24 h of result notification will be screened for eligibility. This time limit ensures that the participating site’s allocated treatment pathway can be initiated early in the disease course. Patients identified only because their condition deteriorated and were deemed to require transfer to a participating hospital for tertiary level care were ineligible as their inclusion would bias our study towards the null hypothesis as most such children will experience the primary outcome shortly after enrollment and would not have received the allocated pathway prior to transfer. Once screened and the clinical care pathway initiated, patients could be approached for study participation (which is limited to data and biospecimen collection as the clinical care pathways are embedded into routine care at study sites) up to 7 days following identification.