Etiologies of Bloody Diarrhea in Children Presenting With Acute Gastroenteritis to US Emergency Departments

Paola Fonseca-Romero; Ben J Brintz; D Matthew Vierkant; Jennifer Dien Bard; Daniel M Cohen; Ara Festekjian; Amy L Leber; Jami T Jackson; Neena Kanwar; Chari Larsen; Rangaraj Selvarangan; Kimberle C Chapin; Andrew T Pavia; Sharia M Ahmed; Daniel T Leung; IMPACT study investigators

doi:10.1093/ofid/ofae692

Etiologies of Bloody Diarrhea in Children Presenting With Acute Gastroenteritis to US Emergency Departments

Open Forum Infect Dis. 2024 Nov 27;11(12):ofae692. doi: 10.1093/ofid/ofae692. eCollection 2024 Dec.

Authors

Paola Fonseca-Romero^{1

2}, Ben J Brintz², D Matthew Vierkant², Jennifer Dien Bard³, Daniel M Cohen⁴, Ara Festekjian³, Amy L Leber⁴, Jami T Jackson⁵, Neena Kanwar⁵, Chari Larsen⁶, Rangaraj Selvarangan⁵, Kimberle C Chapin^{7

8}, Andrew T Pavia^{2

6}, Sharia M Ahmed², Daniel T Leung^{1

2}; IMPACT study investigators

Collaborators

IMPACT study investigators:
Andrew T Pavia, Daniel M Cohen, Amy L Leber, Judy A Daly, Jami T Jackson, Rangaraj Selvarangan, Neena Kanwar, Jeffrey M Bender, Jennifer Dien Bard, Ara Festekjian, Susan Duffy, Chari Larsen, Kristen M Holmberg, Tyler Bardsley, Benjamin Haaland, Kevin M Bourzac, Christopher Stockmann, Kimberle C Chapin, Daniel T Leung

Affiliations

¹ Department of Pathology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.
² Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.
³ Children's Hospital, Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
⁴ Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
⁵ Children's Mercy Hospital, Kansas City, Missouri, USA.
⁶ Department of Pediatrics, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA.
⁷ Deepull, Barcelona, Spain.
⁸ Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.

Abstract

We used molecular testing to examine the causes of bloody diarrhea in a multicenter study of pediatric gastroenteritis. Pathogens typically associated with bloody diarrhea were detected in less than half of cases, and inappropriate antibiotic use was common, supporting the use of stool testing in patients with bloody diarrhea.

Keywords: antibiotic; bloody diarrhea; gastroenteritis; multiplex panel; pediatric.