The Burden of Clostridium difficile in Surgical Patients in the United States

Abstract

Epidemiologic data suggest that the incidence of C. difficile infection is increasing in U.S. surgical patients and that the infection is most prevalent after emergency operations and among patients having intestinal tract resections. Infection with C. difficile is an independent predictor of increased LOS, total charges, and mortality rate after surgery and represents a considerable burden to both patients and hospitals. Preventing C. difficile infection offers a potentially significant improvement in patient outcomes, as well as a reduction in hospital costs and resource expenditures.

Risk for Clostridium difficile infection after radical cystectomy for bladder cancer: Analysis of a contemporary series

“…2,4,5 Recent epidemiologic data suggests that CDI is a growing burden among surgical patients and is associated with increased morbidity, mortality, hospital stay and health care costs. 6,7 The risk of CDI is highest among patients requiring intestinal tract manipulation or reconstruction, a population very similar to patients undergoing radical cystectomy (RC). 6 Other major risk factors for CDI include advanced age and recent antibiotic exposure.…”

“…6,7 The risk of CDI is highest among patients requiring intestinal tract manipulation or reconstruction, a population very similar to patients undergoing radical cystectomy (RC). 6 Other major risk factors for CDI include advanced age and recent antibiotic exposure. 4,[8][9][10] Bladder cancer patients tend to be older and require frequent antimicrobial prophylaxis for pre-and perioperative urinary tract instrumentation, therefore placing them at a higher risk for development of CDI.…”

“…6,16 In a study assessing the outcomes of hospital acquired adverse events in radical cystectomy patients, Kim et al found that patients with CDI had a longer hospital stay by 9 days, and an increase in total hospitalization cost by $21,000 compared to those without adverse events. 11 Similarly, our study found that CDI was associated with longer hospital stays, increased hospital-acquired infections, additional surgical and pharmacotherapies, and higher readmission rates.…”

Clostridium difficile outbreak in Costa Rica: control actions and associated factors

“…The underlying medical conditions associated with CDAD in this outbreak have been described as risk factors mainly in patients who had undergone surgery (18,19). However, association of these underlying medical conditions with CDAD during this outbreak was independent of a history of surgical procedures.…”

Clinical and demographic profile and risk factors for Clostridium difficile infection

“…En un análisis extenso para estimar el impacto de la enfermedad en pacientes sometidos a cirugía en Estados Unidos, Zerey, et al (32), encontraron que la incidencia de C. difficile fue 2,7 veces más alta en los pacientes que fueron operados de emergencia. Además, hallaron que la colectomía (OR=2,77; IC 95% 2,65-2,89), la resección de intestino delgado (OR=2,40;…”