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The “great man” theory inherently excludes women, as it traditionally focuses on leadership features associated with men. In recent years, the healthcare sector has experienced a growing presence of women in leadership roles; however, although female health workers significantly outnumber men, the number of women leaders remains lower than that of men. This article seeks to investigate potential differences between male and female leadership, identify the winning characteristics of female leadership, and examine the barriers and obstacles that may preclude women’s access to leadership positions. A review of existing reviews available on PubMed was conducted using specific search queries. The authors analyzed the selected articles according to specific inclusion and exclusion criteria, using the PICO methodology. Out of 967 articles, 18 met the inclusion criteria. The most frequently identified characteristics of female leadership included a democratic and non-individualistic style, strong communication skills, and empathy. The most common obstacles to the advancement of female leadership included lower compensation, persistent stereotypes and prejudices, and insufficient support from institutions in addressing the gender gap. Academic studies confirm that women tend to adopt a transformational leadership style, in contrast to the more autocratic and assertive male leadership. Further research on female leadership is essential for monitoring progress and fostering actions that allow women to thrive in top leadership positions.

Clostridium difficile infection is a rare event in newborn. Since several studies show a high rate of asymptomatic neonatal colonization by non-toxigenic Clostridium strains, C. difficile is usually not searched in infants and children affected by bloody diarrhea and younger than 12 months. Nevertheless, Clostridium difficile infection should be suspected in patients with bloody diarrhea and other comorbidities. The long term hospitalization and the prolonged exposure to broad-spectrum antibiotic therapy, are also important risk factors for intestinal infection. We present the case of a 10-day newborn with thrombocytopenia associated with rectorrhagia and positivity of inflammation indices. Transfusion of platelets and immunoglobulins was performed with platelet normalization and empiric antibiotic therapy was practiced (ampicillin and gentamicin). A sudden clinical worsening occurred after ten day: he developed severe bloody diarrhea with systemic failure. Laboratory tests showed: neutrophilic leukocytosis,thrombocytosis, anemia, an important increase in inflammation indices. Several abdomen X-ray showed moderate gaseous distension of some intestinal loops with presence of hydroaerial levels. Abdominal ultrasound revealed diffuse thickening of the colon walls (a sign of colitis). The search of C. difficile in stools sample was positive for C. difficile producer of Toxin A and toxin B Enzym Immunoassay (EIA). The infant was successfully treated with vancomycin and metronidazole, without relapsing.

Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% ( n  = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis.  Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques. What is Known: • Several guidelines are published on the management of children with suspected or confirmed urinary tract infection. •  No data are available on the management of pediatric urinary tract infections in the emergency setting. What is New: •  Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture. •  Diagnostic CFU thresholds largely vary among centers.

Doc number: A46

Doc number: A52