Surgical aspects of Clostridium difficile colitis.

BACKGROUND: There has been a marked increase in the number of surgical patients developing Clostridium difficile colitis. The epidemiology, pathogenesis, diagnosis and management of C. difficile infection were reviewed from a surgical perspective.
METHODS: A literature review was carried out based primarily on a Medline search of all English language publications containing the term C. difficile.
RESULTS: The recent dramatic increase in diagnosis of C. difficile infection amongst surgical patients results from heightened awareness of the condition, better methods of diagnosis, more widespread use of antibiotics for treatment and prophylaxis, and the increasing numbers of elderly and immunocompromised patients with malignancy, sepsis, and (multiple) organ failure being cared for within intensive therapy and high-dependency units. In addition to morbidity and mortality, the economic burden of C. difficile infection in terms of delayed discharge and other hospital costs is considerable.
CONCLUSION: Appropriate use of antibiotics, isolation of affected patients and meticulous hygiene measures on the part of staff are vital if the morbidity, mortality and economic consequences of this nosocomial infection are to be minimized.