Excluding children with Shiga toxin-producing Escherichia coli (STEC) from childcare until microbiologically clear of the pathogen, disrupts families, education, and earnings. Since PCR introduction, non-O157 STEC serotype detections in England have increased. We examined shedding duration by serotype and transmission risk, to guide exclusion advice. We investigated STEC cases aged <6 years, residing in England and attending childcare, with diarrhoea onset or sample date from 31 March 2018 to 30 March 2022. Duration of shedding was the interval between date of onset or date first positive specimen and earliest available negative specimen date. Transmission risk was estimated from proportions with secondary cases in settings attended by infectious cases. There were 367 cases (STEC O157 n = 243, 66.2%; STEC non-O157 n = 124, 33.8%). Median shedding duration was 32 days (IQR 20–44) with no significant difference between O157 and non-O157; 2% (n = 6) of cases shed for ≥100 days. Duration of shedding was reduced by 17% (95% CI 4–29) among cases reporting bloody diarrhoea. Sixteen settings underwent screening; four had secondary cases (close contacts’ secondary transmission rate = 13%). Shedding duration estimates were consistent with previous studies (median 31 days, IQR 17–41). Findings do not warrant guidance changes regarding exclusion and supervised return of prolonged shedders, despite serotype changes.

将患有产志贺毒素大肠杆菌(STEC) 的儿童排除在托儿所之外，直到微生物学上清除了病原体，这会扰乱家庭、教育和收入。自从引入 PCR 以来，英格兰的非 O157 STEC 血清型检测有所增加。我们根据血清型和传播风险检查了排毒持续时间，以指导排除建议。我们调查了年龄 <6 岁、居住在英格兰并参加托儿所的 STEC 病例，腹泻发作或采样日期为 2018 年 3 月 31 日至 2022 年 3 月 30 日。排泄持续时间是发病日期或第一个阳性标本日期与最早获得的阴性标本之间的时间间隔标本日期。传播风险是根据感染病例所在环境中继发病例的比例来估计的。共有 367 例病例（STEC O157 n  = 243，66.2%；STEC 非 O157 n  = 124，33.8%）。中位脱落持续时间为 32 天（IQR 20-44），O157 和非 O157 之间没有显着差异；2% ( n  = 6) 的病例脱落时间≥100 天。在报告血性腹泻的病例中，排泄持续时间减少了 17% (95% CI 4-29)。十六个场所经过筛选；4 例出现继发病例（密切接触者继发传播率 = 13%）。脱落持续时间估计与之前的研究一致（中位 31 天，IQR 17-41）。尽管血清型发生了变化，但研究结果并不能保证对长期脱落者的排除和监督返回的指导进行改变。