Postoperative Clostridium difficile-associated diarrhea

Southern, William N.; Rahmani, Rabin; Aroniadis, Olga C.; Khorshidi, Igal; Thanjan, Andy; Ibrahim, Christopher B.; Brandt, Lawrence J.

doi:10.1016/j.surg.2009.11.021

Cited by 42 publications

(43 citation statements)

References 38 publications

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“…Table 1 shows the main characteristics of the included studies. The majority of the studies were conducted in North America (n = 26) [13,14,[16][17][18][19][20]23,[25][26][27]31,33,34,38,40,41,[43][44][45][46][47][48][49][50][51], whilst 7 were conducted in Europe (mainly in the UK) [21,22,[28][29][30]32,35]. One more study included patients from North America and the UK [15], four from Asia (South Korea and Taiwan) [36,37,39,42] and one from Argentina [24].…”

Section: Data Synthesis and Analysismentioning

confidence: 99%

“…In 5 of the 18 non-profit-funded studies the authors reported having received grants from pharmaceutical companies [19,25,27,34,49], as did 1 of the 11 studies for which no funding was reported [31]. In 14 studies the authors reported no conflicts of interest [13,22,24,29,30,32,33,40,41,[43][44][45]48,50], whilst in the remaining 9 studies no data regarding conflict of interest were reported [26,[35][36][37]39,42,46,47,51].…”

Section: Figurementioning

confidence: 99%

See 1 more Smart Citation

Treatment failure and recurrence of Clostridium difficile infection following treatment with vancomycin or metronidazole: a systematic review of the evidence

Vardakas

Polyzos

Patouni

et al. 2012

International Journal of Antimicrobial Agents

224

162

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Section: Data Synthesis and Analysismentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Treatment failure and recurrence of Clostridium difficile infection following treatment with vancomycin or metronidazole: a systematic review of the evidence

Vardakas

Polyzos

Patouni

et al. 2012

International Journal of Antimicrobial Agents

224

162

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“…However newer studies show that there was no clear association between overall cephalosporin usage (or any cephalosporin) and CDI incidence [17]. The prophylactic dose given immediately before surgery is associated with dramatically reduced rates of wound infection and post-operative sepsis [18]. It is likely that any slightly increased risk of post-operative CDI associated with such prophylactic use of antibiotics would be outweighed by benefit [8].…”

Section: Discussionmentioning

confidence: 99%

Clostridium Difficile Infection - An Optimistic View

Frunza¹,

Rotundu²,

Morărașu³

et al. 2017

Surgery

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Journal of Surgery IntroductionClostridium difficile is an anaerobic, Gram-positive, spore-forming, toxin-producing bacteria identified as a cause of colitis associated with antibiotic use [1]. Previous exposure to antibiotics is the most important risk factor for CDI, leading to modification of the normal flora of the colon and decreasing the intestine's resistance to colonization [2]. Other risk factors for CDI are inflammatory bowel disease, immunodeficiency, hypoalbuminemia, malignancies, organ transplantation and mechanical bowel preparation. Despite the development of CDI therapy there is a growing incidence, severity, mortality and recurrence of this condition [3]. The high rate of recurrent CDI raises a question mark over current treatment recommendations of the first episodes of CDI [4,5]. Materials and MethodsWe identified all reported cases of CDI during the period of 2014-2016 using the digital database of the center for control, surveillance, and prevention of transmissible diseases in the Regional Oncologic Institute Iasi. All cases are registered in the database immediately after diagnosis, followed by epidemiological investigation and standardized protocols for isolation and protection of contacts. The admission charts were studied to extract the following information: age, sex, date of admission and release, date of CDI confirmation and toxin negativity. We also checked for antibiotic use in the last 3 months, administration of gastricantisecretory medication, previous hospitalization or contact with CDIconfirmed patients. For the surgical cases we gathered data about the date and type of intervention performed. Diagnosis of Clostridium difficile colitisEven if symptoms can be variable, typical symptom is watery diarrhea up to 15-30 stools per day [1,3]. Some patients can complain AbstractBackground: Clostridium difficile infection (CDI) is one of the most common infectious complications affecting vulnerable patients, i.e., after surgery or immunosuppressive therapies, posing a significant risk in an oncological unit. Materials and methods:We analyzed data recovered from 164 cases of CDI during the period of 2014-2016 in the Regional Oncologic Institute Iasi, majority admitted in the surgical and hematological units. In all cases diagnostic was confirmed if stool samples tested positive for GDH and at least one of the toxins A or B. Results:The study shows a large population of elder patients (median age 64 years) with female dominance (54%). Out of 117 surgical cases 64% had surgical procedures on the gastro-intestinal tract. Although 20% of patients had equivocal symptoms from admission, the average interval (from admission) until first symptoms developed was 7 days. The confirmation of the diagnosis came in the next day/24h in 68% of cases, leading to initiation of efficient therapy. Although CDI is regarded as an antibiotic associated disease, our data revealed that only one third of patients received antibiotic treatment in the last 3 months. Among the risk factors that may have an influen...

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“…Die PPI-induzierte Säuresuppression stellt einen Risikofaktor für die Clostridium-difficile-assoziierte Diarrhö (CDAD) bei hospitalisierten Patienten dar [2,46].…”

Section: Clostridium-difficileassoziierte Diarrhöunclassified

“…Dies ist auch für die postoperative CDAD in einem großen chirurgischen Patientenkollektiv gezeigt worden [46]: Die analysierte Serie umfasste 3904 Patienten mit abdominalchirurgischem Eingriff, von denen 46 postoperativ eine CDAD erlitten hatten. Im Vergleich zu allen Patienten hatten die Patienten mit CDAD (neben höherem Lebensalter, häufigerer Antibiotikaeinnahme und mehr vorangegangenen Krankenhausaufenthalten) auch häufiger eine PPI-Medikation im Vergleich zum Gesamtkollektiv (28,3% vs. 10,0%, p<0,001).…”

Section: Clostridium-difficileassoziierte Diarrhöunclassified

Neu erkannte Nebenwirkungen von Protonenpumpeninhibitoren

Rahden

Scheurlen

Filser

et al. 2011

Chirurg

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Among other indications proton pump inhibitors (PPIs) are used as medical treatment of gastroesophageal reflux disease (GERD) and are the most frequently prescribed and most frequently used drugs in gastroenterology. Until recently PPIs were regarded as very safe and associated with very few side-effects. However, during recent years study results have revealed many severe adverse events associated especially with long-term PPI use. We review the currently available evidence, regarding the side-effects of PPIs and discuss the potential impact on treatment strategies for GERD (conservative treatment vs. antireflux surgery). Currently available data suggest that PPIs are associated with osteoporosis-related fractures, Clostridium difficile associated diarrhea (CDAD), community and hospital-acquired pneumonia, pharmacologic interaction with clopidogrel and acetylsalicylic acid with subsequent increased rate of cardiovascular events, refractory hypomagnesemia and rebound reflux symptoms etc. The risk-benefit ratio of PPIs is increasingly recognized as being less favourable. This leads to a more critical viewpoint and raises the question whether the side-effects of PPIs may outweigh the benefits, especially with long-term use. The side-effects of PPIs seem to make a strong argument in favour of laparoscopic fundoplication in the treatment of GERD.

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Postoperative Clostridium difficile-associated diarrhea

Cited by 42 publications

References 38 publications

Treatment failure and recurrence of Clostridium difficile infection following treatment with vancomycin or metronidazole: a systematic review of the evidence

Treatment failure and recurrence of Clostridium difficile infection following treatment with vancomycin or metronidazole: a systematic review of the evidence

Clostridium Difficile Infection - An Optimistic View

Neu erkannte Nebenwirkungen von Protonenpumpeninhibitoren

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