Clostridium difficile colonization in preoperative colorectal cancer patients

Abstract

The entire process of Clostridium difficile colonization to infection develops in large intestine. However, the real colonization pattern of C. difficile in preoperative colorectal cancer patients has not been studied. In this study, 33 C. difficile strains (16.1%) were isolated from stool samples of 205 preoperative colorectal cancer patients. C. difficile colonization rates in lymph node metastasis patients (22.3%) were significantly higher than lymph node negative patients (10.8%) (OR=2.314, 95%CI=1.023-5.235, P =0.025). Meanwhile, patients positive for stool occult blood had lower C. difficile colonization rates than negative patients (11.5% vs. 24.0%, OR=0.300, 95%CI=0.131-0.685, P =0.019). A total of 16 sequence types were revealed by multilocus sequence typing. Minimum spanning tree and time-space cluster analysis indicated that all C. difficile isolates were epidemiologically unrelated. Antibiotic susceptibility testing showed all isolates were susceptible to vancomycin and metronidazole. The results suggested that the prevalence of C. difficile colonization is high in preoperative colorectal cancer patients, and the colonization is not acquired in the hospital. Since lymph node metastasis colorectal cancer patients inevitably require adjuvant chemotherapy and C. difficile infection may halt the ongoing treatment, the call for sustained monitoring of C. difficile in those patients is apparently urgent.

<p>Adequate Lymph Node Assessments and Investigation of Gut Microorganisms and Microbial Metabolites in Colorectal Cancer</p>

“…17,18 Large numbers of studies have shown that CRC patients have characteristic microbes, including Fusobacteria, Streptococcus, and Clostridium in their intestines. [19][20][21][22] Gut microorganisms are involved in the development and progression of CRCs through many pathways such as through the induction of inflammation and biosynthesis of genotoxins. 23,24 Recent studies have suggested that the occurrence of CRCs is not only the function of a single microorganism, but also the result of the disruption of dynamic equilibrium of the gut microecology.…”

The diagnostic delay and treatment outcome of <i>Clostridium difficile</i> infection in the patients who underwent rectal surgery

“…Few studies have examined the incidence rate of CDI in CRC patients. In recently, a team of researchers from Memorial Sloan Kettering Cancer Center and China investigated the pattern of C. difficile colonization in preoperative CRC patients [4], and the changes in the gut microbiota composition from the CRC would be associated with increased risk for CDI. But there are no comparative studies for the incidence rate between RG and CG, at least in our review.…”

Clostridium Difficile Infection - An Optimistic View

“…A recent study suggested that the prevalence of C. difficile colonization is high in preoperative colorectal cancer patients, and the colonization is not acquired in the hospital. Antibiotic susceptibility testing showed all isolates were susceptible to vancomycin and metronidazole [24].…”

“…A recent study suggested that the prevalence of C. difficile colonization is high in preoperative colorectal cancer patients, and the colonization is not acquired in the hospital. Antibiotic susceptibility testing showed all isolates were susceptible to vancomycin and metronidazole [24].We must note that all interventions in our institution were performed in an elective manner, being a known fact that patients undergoing an emergency operation are at higher risk of developing CDI than those having operations performed electively [25]. These types of interventions are usually followed by a number of postoperative complications.…”