How potential participants will be identified and approached
STEC, HUS, hyperhydration, STEC infection
BLOODY DIARRHEA
Participant identification/approach will vary between sites, but will be based on the following key concepts:Clinician identification: once a child is identified as having a high-risk STEC infection, clinicians will provide patients/caregivers with an STEC information sheet which clearly states that the site is participating in this study, the institution’s treatment approach within the study, and the pros/cons of the two treatment protocols. Clinicians at all sites will be trained to contact the appropriate research team member to determine research eligibility and to obtain permission for the research team to approach the caregiver to request informed consent for data extraction and biospecimen collection.Research team identification:Daily screening: reports from the ED and inpatient units will be created to identify all children with potentially eligible chief complaints (e.g., bloody diarrhea, abnormal laboratory result) and discharge diagnoses (e.g., STEC, HUS). Patients infected with a high-risk STEC (evidence of an Medical microbiology laboratory identification: reports identifying all STEC positive stool specimens will be set up. For all children identified potentially eligible children, contact will be initiated by the research team with the responsible physician who will be informed of the sites allocated pathway and who will be asked to obtain consent for the research team to approach the family.Approach to optimize the enrollment of high-risk STEC infected participantsFor all discharged and outpatients, the child will be asked to go to the ED (if required for the hyperhydration arm) for screening (i.e., baseline laboratory testing) and treatment per the institution allocated pathway. If in the conservative fluid management arm, at the discretion of the responsible physician, the child may be managed as an outpatient and consented for research electronically.