Clostridium difficile colitis: An increasing hospital-acquired illness

Blair A. Jobe, Andrew Grasley, Karen E. Deveney, Clifford W. Deveney, Brett C. Sheppard

Research output: Contribution to journalArticle

158 Scopus citations

Abstract

Colitis caused by itClostridium difficile is receiving increased attention as a nosocomial hospital-acquired infection. To determine the incidence of C difficile colitis in our facility and the relative proportion of patients dying from the colitis or requiring colectomy for it, we retrospectively reviewed 201 cases of colitis caused by C difficile from 1984 to 1994. The incidence of C difficile colitis appears to be sharply increasing and is associated with the use of cephalosporins. Among patients who subsequently developed C difficile colitis, the most frequent indication for antibiotic use was perioperative prophylaxis; surgical patients comprised 55% of the total cases. Surgical intervention was required for 5% of patients with C difficile colitis, with an operative mortality of 30%. The overall mortality was 3.5% and was associated with a delay in diagnosis. The only discriminative factor between patients who died and those who survived was length of time from symptoms to treatment-5.43 days for survivors versus 10.7 days for those who died (P <0.05). Most cases of C difficile colitis seen by surgeons have followed the use of perioperative prophylactic antibiotics. Strict guide-lines for using perioperative antibiotics should be observed. Prompt recognition of C difficile colitis and aggressive therapy for it are essential for a favorable outcome.

Original languageEnglish (US)
Pages (from-to)480-483
Number of pages4
JournalAmerican journal of surgery
Volume169
Issue number5
DOIs
StatePublished - Jan 1 1995

ASJC Scopus subject areas

  • Surgery

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