OBJECTIVES: To determine the impact of Escherichia coli O157:H7 infection in children on the need for surgical assessment in a pediatric surgical practice and whether clinical and bacteriologic variables might contribute to that need. DESIGN: Examination of a case series. SETTING: A tertiary-care pediatric hospital. PATIENTS: Between 1990 and 1994, E. coli O157:H7 gastrointestinal infections were documented among 85 children, 29 of whom suffered from hemolytic-uremic syndrome. INTERVENTION: Surgical consultation for presumed or proven complications of the infection. MAIN OUTCOME MEASURES: The frequency of and reasons for surgical consultation, clinical and bacteriologic variables between patients who did or did not require surgical assessment. RESULTS: Of the 85 children, 17 (20%) were assessed by the surgical service. The majority of these children were inpatients. Two required abdominal surgery. Female gender, older age and progression to hemolytic-uremic syndrome were factors associated in univariate analyses with a likelihood of need for surgical assessment; variation in bacterial genotype was not. CONCLUSION: There is the potential for verotoxigenic E. coli O157:H7 infection to have a considerable impact on the utilization of pediatric surgical services.
OBJECTIVES: To determine the impact of Escherichia coli O157:H7infection in children on the need for surgical assessment in a pediatric surgical practice and whether clinical and bacteriologic variables might contribute to that need. DESIGN: Examination of a case series. SETTING: A tertiary-care pediatric hospital. PATIENTS: Between 1990 and 1994, E. coli O157:H7gastrointestinal infections were documented among 85 children, 29 of whom suffered from hemolytic-uremic syndrome. INTERVENTION: Surgical consultation for presumed or proven complications of the infection. MAIN OUTCOME MEASURES: The frequency of and reasons for surgical consultation, clinical and bacteriologic variables between patients who did or did not require surgical assessment. RESULTS: Of the 85 children, 17 (20%) were assessed by the surgical service. The majority of these children were inpatients. Two required abdominal surgery. Female gender, older age and progression to hemolytic-uremic syndrome were factors associated in univariate analyses with a likelihood of need for surgical assessment; variation in bacterial genotype was not. CONCLUSION: There is the potential for verotoxigenic E. coli O157:H7infection to have a considerable impact on the utilization of pediatric surgical services.