First, it is clear that a large number of SLT producing bacteria have the potential to cause HUS, particularly among children. The second key issue raised by the latter two papers concerns treatment of bloody diarrhea. Saeed et al. note that the wide variety of antibiotics used to treat bloody diarrhea in Saudi Arabia could be explained by the various prescription practices of doctors recruited from different parts of the world.
Antibiotic resistance is a worrying component of the mechanisms of emerging infectious diseases.
Inappropriate antibiotic use is a key factor in the development of resistance, and major efforts must be directed towards educating physicians on effective prescribing practices. Goldwater and Bettelheim discuss the characteristic disappearance of E. coli from patients' stools after the development of HUS and, therefore, the importance of early detection in cases of bloody diarrhea. However, testing can be difficult, time-consuming and costly. This must surely be considered when contemplating the costs of surveillance. A national surveillance scheme for HUS was established in 1994, although notification is not mandatory.