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Clostridium difficile colitis in surgical patients.

J M Rosenberg, M Walker, J P Welch

    American Journal of Surgery
    |April 1, 1984
    PubMed
    Summary
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    Clostridioides difficile (C. diff) infection causes antibiotic-associated diarrhea in elderly, immunocompromised patients. Prompt diagnosis and treatment, including antibiotic withdrawal or specific therapies, are crucial for patient recovery and preventing spread.

    Area of Science:

    • Infectious Diseases
    • Gastroenterology
    • Hospital Epidemiology

    Background:

    • Clostridioides difficile (C. diff) infection is a significant cause of antibiotic-associated diarrhea.
    • Understanding the clinical course and risk factors is essential for effective management and infection control.

    Observation:

    • A study examined 75 patients with C. diff toxin-positive diarrhea, with a mean age of 68.
    • High incidence observed in surgical units, with many patients being immunocompromised (cancer, sepsis, diabetes).
    • Diarrhea onset typically occurred 2.7 days post-antibiotic initiation, often accompanied by fever and leukocytosis.

    Findings:

    • Antibiotic withdrawal resolved diarrhea in 30% of patients.
    • The remaining 70% required specific treatments like vancomycin, bacitracin, or metronidazole.

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  • Two deaths were directly linked to C. diff colitis, and hospital stays were frequently prolonged.

    • Implications:

    • C. diff colitis should be suspected in patients developing diarrhea during or after antibiotic therapy.
    • Implementing enteric precautions can prevent C. diff transmission and colonization in susceptible individuals.
    • Early recognition and appropriate management strategies are vital to reduce morbidity and mortality associated with C. diff infections.