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Clostridium difficile: What is the risk?

Esther K Liu1, Janae Preece2, Kristina D Suson2

  • 1Department of Urology, Detroit Medical Center, Harper Professional Building, 4160 John R Suite 1017, Detroit, MI 48201, USA.

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|September 26, 2022
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Summary
This summary is machine-generated.

Postoperative Clostridium difficile infections (CDI) are rare in pediatric urologic surgery patients, occurring in only 0.13% of cases. When CDI does occur, it is associated with longer hospital stays and increased readmissions.

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Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Urology

Background:

  • Clostridium difficile infections (CDIs) are increasingly prevalent in pediatric populations, with higher risks observed in transplant and bowel surgery patients.
  • Renal surgery is associated with a lower risk of CDI, prompting investigation into other surgical specialties like pediatric urology.

Purpose of the Study:

  • To investigate the incidence of postoperative CDI in pediatric patients undergoing urologic procedures.
  • To identify perioperative factors associated with CDI development in this patient cohort.

Main Methods:

  • A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program Pediatric data file (2015-2017).
  • Inclusion of patients undergoing pediatric urology or urology procedures, with data points on demographics, surgical details, and perioperative outcomes.
  • Statistical analyses (t-tests and chi-square) were used to compare patients with and without CDI.

Main Results:

  • Of 27,193 patients, 36 (0.13%) developed CDI. Patients with CDI were more likely to be female and have higher ASA classifications.
  • CDI cases were associated with significantly longer operative times (156.1 min vs. 105.2 min) and hospital stays (4.6 days vs. 1.3 days).
  • Patients with CDI had higher complication rates (29% vs. 6%) and readmission rates (56% vs. 4%), with vesicoureteral reflux correction and nephrectomy being the most common procedures among CDI cases.

Conclusions:

  • Postoperative CDI is uncommon following pediatric urologic procedures.
  • Although rare, CDI in this population is linked to adverse outcomes including extended hospital stays, increased readmissions, and higher rates of other complications.