Patients whose symptoms of Clostridium difficile infection (CDI) start outside of the hospital setting have a higher risk of colectomy due to severe infection, according to a large multicenter study funded by the Centers for Disease Control and Prevention (CDC) and published in the May 2012 issue of the journal Infection Control and Hospital Epidemiology.
Infection from C. difficile is associated with antibiotic use and results in colitis and diarrhea. Severe cases can be life-threatening. Colectomy, or surgical removal of most or all of the large intestine, is the treatment of choice for patients who have life-threatening CDI that does not respond to medical therapy. However, it is associated with a high risk of death in these very sick patients.
To assess rates of colectomy due to CDI, a team of researchers at 5 tertiary-care hospitals in the US collected data on CDI cases over a six year period from 2000 and 2006. They identified 8,569 cases of CDI, and 75 patients of this group underwent a colectomy due to severe CDI, a rate of 8.7 colectomies per 1000 CDI cases. Patients with community onset CDI had colectomy rates four times higher than patients who developed symptoms while hospitalized. Individuals who were 65 years old or older were also more likely to have a CDI-related colectomy.
Patients in the community were previously considered to be at low risk for CDI. A recent CDC Vital Signs reported that 75 percent of CDI symptoms first show in community settings like nursing home patients or in people recently cared for in doctors offices and clinics. Together these findings illustrate the increasing trend and severity of community onset CDI.
Future prospective surveillance studies using standardize case definitions are needed to better characterize severe complications from CDI and to help healthcare providers decide which patients would potentially benefit from surgical intervention.
Reference: Kasper AM, et al. A Multicenter Study of Clostridium difficile InfectionRelated Colectomy, 20002006. Infection Control and Hospital Epidemiology 33:5. May 2012.
CDC Urges Vigilance: New Recommendations for Monitoring and Testing H5N1 Exposures
July 11th 2025With avian influenza A(H5N1) infections surfacing in both animals and humans, the CDC has issued updated guidance calling for aggressive monitoring and targeted testing to contain the virus and protect public health.
IP LifeLine: Layoffs and the Evolving Job Market Landscape for Infection Preventionists
July 11th 2025Infection preventionists, once hailed as indispensable during the pandemic, now face a sobering reality: budget pressures, hiring freezes, and layoffs are reshaping the field, leaving many IPs worried about their future and questioning their value within health care organizations.
A Helping Hand: Innovative Approaches to Expanding Hand Hygiene Programs in Acute Care Settings
July 9th 2025Who knew candy, UV lights, and a college kid in scrubs could double hand hygiene adherence? A Pennsylvania hospital’s creative shake-up of its infection prevention program shows that sometimes it takes more than soap to get hands clean—and keep them that way.