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Clostridium difficile colitis: an increasing hospital-acquired illness
B A Jobe1, A Grasley, K E Deveney
1Department of Surgery, Oregon Health Sciences University, Portland, USA.
American Journal of Surgery
|May 1, 1995
Summary
Clostridium difficile colitis is increasing, often linked to cephalosporin use for surgical prophylaxis. Prompt diagnosis and treatment are crucial for survival in these hospital-acquired infections.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Infections
Background:
- Clostridium difficile (C. diff) colitis is an emerging nosocomial infection.
- Increasing attention is being paid to C. diff colitis as a hospital-acquired infection.
Purpose of the Study:
- To determine the incidence of C. diff colitis.
- To assess the proportion of patients dying from or requiring colectomy for C. diff colitis.
Main Methods:
- Retrospective review of 201 C. diff colitis cases from 1984 to 1994.
- Analysis of patient data including antibiotic use, surgical intervention, and outcomes.
Main Results:
- C. diff colitis incidence is sharply increasing, associated with cephalosporin use.
- Perioperative prophylaxis was the most common antibiotic indication (55% surgical patients).
- Surgical intervention was needed in 5% of cases (30% operative mortality). Delayed diagnosis increased overall mortality (3.5%), with time to treatment being a key factor.
Conclusions:
- Many C. diff colitis cases in surgical patients follow perioperative antibiotic use.
- Strict guidelines for perioperative antibiotics are recommended.
- Prompt recognition and aggressive therapy are essential for favorable outcomes in C. diff colitis.