Clostridium colitis at a surgical department
Authors:
L. Urbánek 1; I. Čapov 1; J. Cagaš 1; R. Tejkalová 2; J. Kratochvílová 3
Authors place of work:
I. chirurgická klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice u svaté Anny v Brně
přednota: Prof. MUDr. I. Čapov, CSc.
1; Mikrobiologický ústav Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice u svaté Anny
v Brně, přednota: Doc. MUDr. F. Růžička, Ph. D.
2; Oddělení hygieny a epidemiologie Fakultní nemocnice u svaté Anny v Brně
vedoucí oddělení MUDr. J. Kratochvílová
3
Published in the journal:
Rozhl. Chir., 2014, roč. 93, č. 2, s. 70-75.
Category:
Original articles
Práce je věnována prof. MUDr. Janu Wechslerovi u příležitosti jeho 75. narozenin.
Summary
Introduction:
The aim of our study was to identify risk factors associated with the development of Clostridium difficile colitis and determining the severity of clostridial colitis in a group of surgical patients. Identification of its predispositions is necessary for preventive interventions and effective treatment.
Material and methods:
51 patients diagnosed with clostridial colitis were included in our study. The inclusion criterion was based on laboratory detection of clostridial toxin in each patient. We analysed age, concomitant malignancy, recent surgical intervention, antibiotic and proton pump inhibitors treatment. The severity of clostridial colitis and its correlation to possible risk factors mentioned above was described and statistically evaluated. Non-parametric Fischer test was used for the statistical evaluation.
Results:
We confirmed the importance of potential risk factors in the evaluated group of surgical patients with Cl. difficile colitis. The course of the disease was described as serious in 39.2% of patients in the study group. Recurrent attack of colitis was diagnosed in 4 patients, in 2 of them the second recurrence, in 1 patient the third relapse occurred. 2 patients with clostridial colitis evaluated in our group died, but the relation of their death to the clostridial GIT infection was not causal and the primary cause of death in both of them was multiple organ failure caused by serious comorbidities. We did not indicate any surgical intervention and no toxic megacolon developed in our study group. We did not detect any statistical correlation between the described risk factors and the severity of colitis.
Conclusion:
Clostridium difficile colitis needs to be recognised as a serious complication, especially in hospitalised patients. Its increased frequency and severity should not be underestimated. Although we can identify potential risk factors, we cannot exclude some of them completely (e.g. antibiotic and PPI treatment). On the other hand, a rational approach to antibiotic treatment in particular can be helpful in reducing the frequency and severity of clostridium difficile colitis.
Key words:
clostridium colitis – Clostridium difficile – risk factors
Zdroje
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Štítky
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