Clostridium difficile colitis: A clinical review

Am J Surg. 2017 Mar;213(3):565-571. doi: 10.1016/j.amjsurg.2016.10.035. Epub 2017 Jan 3.

Abstract

Background: Clostridium difficile colitis is an important cause of morbidity and mortality in the surgical patient. In recent years, Clostridium difficile infections have shown marked increases in frequency, severity, and resistance to standard treatment. With urgent operative interventions and novel endoscopic approaches, pseudomembranous colitis is being seen more commonly in surgical practices.

Data sources: In this paper, we will review a number of papers from the literature. We will discuss the epidemiology, evaluation and treatment of Clostridium difficile infection. Fulminant colitis may require emergency operation. For the surgical endoscopist, fecal microbiota transplantation restores the gastrointestinal flora, and has been shown to be effective in more than 80% of patients.

Conclusion: Clostridium difficile infection is a major cause of healthcare-related diarrhea leading to increased morbidity and mortality in surgical patients. Increases in failure rates and resistance to current treatments are clinical and economic challenges in the healthcare situation.

Keywords: Antibiotic-associated diarrhea; Clostridium difficile colitis; Clostridium difficile infection; Diarrhea; Fecal microbiota transplantation; Inflammatory bowel disease; Pseudomembranous colitis.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Clostridioides difficile
  • Clostridium Infections / diagnosis
  • Clostridium Infections / epidemiology
  • Clostridium Infections / therapy*
  • Colectomy
  • Donor Selection
  • Fecal Microbiota Transplantation
  • Humans
  • Inflammatory Bowel Diseases / microbiology
  • Severity of Illness Index
  • Therapeutic Irrigation

Substances

  • Anti-Bacterial Agents