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Open AccessArticle

Clostridium difficile Infection and Colorectal Surgery: Is There Any Risk?

Elias University Emergency Hospital, 011461 Bucharest, Romania
Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
Author to whom correspondence should be addressed.
Medicina 2019, 55(10), 683;
Received: 8 July 2019 / Revised: 2 October 2019 / Accepted: 3 October 2019 / Published: 10 October 2019
Background and objectives: Clostridium difficile infection (CDI) is an important healthcare-associated infection, with important consequences both from a medical and financial point of view, but its correlation with anastomotic leaks after colorectal surgeries is scarcely reported in the literature. Materials and Methods: We conducted a retrospective study looking for patients who underwent open or laparoscopic surgery for colorectal cancers between January 2012 and December 2017, excluding emergency surgeries for complicated colorectal tumors. We also examined patient history for risk factors for CDI such as age, sex, comorbidities, and clinical findings at admission or during hospital stay as well as tumor characteristics. Results: A total of 360 patients were included in the study, out of which 320 underwent surgeries that included anastomoses. There were 19 cases of anastomotic leaks, out of which 13 patients were diagnosed with CDI, with a statistic significance for association between CDI and anastomotic leakage (p < 0.0001). Most patients who developed both CDI and anastomotic leaks had left-sided resections or a type of rectal resection, while none of the patients with right-sided resections had this association, but with no statistical significance possibly due to the limited number of cases. Conclusions: CDI is a relevant risk factor and should be taken into consideration when trying to prevent anastomotic leaks in patients undergoing gastrointestinal surgery for colon or rectal cancer. Thorough assessment of risk factors at admission should be mandatory in order to adequately prepare the patient and plan an optimal course of treatment. Further studies are needed to confirm our findings and a multidisciplinary approach, with a team which should always include the surgeon, is mandatory when it comes to CDI prevention. View Full-Text
Keywords: Clostridium difficile infection; colorectal surgery; anastomotic leakage Clostridium difficile infection; colorectal surgery; anastomotic leakage
MDPI and ACS Style

Calu, V.; Toma, E.-A.; Enciu, O.; Miron, A. Clostridium difficile Infection and Colorectal Surgery: Is There Any Risk? Medicina 2019, 55, 683.

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