Clostridium difficile-Associated Diarrhoea After Internal Fixation of Intertrochanteric Femoral Fractures

Concise Article

Abstract

The aim of the study presented here was to record the incidence and outcome of Clostridium difficile-associated diarrhoea in patients undergoing surgery for intertrochanteric femoral fractures. Between January 2000 and June 2001, a total of 239 patients who underwent surgery after sustaining an intertrochanteric femoral fracture were included in the study. Seventeen patients developed Clostridium difficile-associated diarrhoea (incidence risk, 7.1%), and six patients died after developing the condition (case fatality rate, 35%). Thus, Clostridium difficile-associated diarrhoea was found to cause significant morbidity and mortality after surgery for intertrochanteric femoral fractures, and antibiotics should be used judiciously in this group of patients.

References

  1. 1.
    Harbarth S, Samore MH, Carmeli Y (2001) Antibiotic prophylaxis and the risk of Clostridium difficile-associated diarrhoea. J Hosp Infect 48:93–97CrossRefPubMedGoogle Scholar
  2. 2.
    Yee J, Dixon CM, McLean AP, Meakins JL (1991) Clostridium difficile disease in a department of surgery. The significance of prophylactic antibiotics. Arch Surg 126:241–246PubMedGoogle Scholar
  3. 3.
    Clarke HJ, Jinnah RH, Byank RP, Cox QGN (1990) Clostridium difficile infection in orthopaedic patients. J Bone Joint Surg Am 72:1056–1059PubMedGoogle Scholar
  4. 4.
    Cannon SR, Dyson PHP, Sanderson PJ (1988) Pseudomembranous colitis associated with antibiotic prophylaxis in orthopaedic surgery. J Bone Joint Surg Br 70:600–602PubMedGoogle Scholar
  5. 5.
    Dallal RM, Harbrecht BG, Boujoukas AJ, et al (2001) Fulminant Clostridium difficile: An underappreciated and increasing cause of death and complications. Ann Surg 235:363–372CrossRefGoogle Scholar
  6. 6.
    Marts BC, Longo WE, Vernava AM, et al (1994) Patterns and prognosis of Clostridium difficile. Dis Colon Rectum 37:837–845PubMedGoogle Scholar
  7. 7.
    van Dalen T, van Dijk Y, Kaan JA, Deipersloot RJ, Leguit P (1998) [Clostridium difficile outbreak in surgical wards]. Ned Tijdschr Geneeskd 142:253–255PubMedGoogle Scholar
  8. 8.
    Eriksson S, Aronsson B (1989) Medical implications of nosocomial infection with Clostridium difficile. Scand J Infect Dis 21:733–734PubMedGoogle Scholar
  9. 9.
    Morris AM, Jobe BA, Stoney M, Sheppard BC, Deveney CW, Deveney KE (2002) Clostridium difficle colitis: an increasingly aggressive iatrogenic disease? Arch Surg 137:1096–1100CrossRefPubMedGoogle Scholar
  10. 10.
    Jobe BA, Grasley A, Deveney KE, Deveney CW, Sheppard BC (1995) Clostridium difficle colitis: an increasing hospital-acquired illness. Am J Surg 169:480–483CrossRefPubMedGoogle Scholar
  11. 11.
    Prendergast TM, Marini CP, D'Angelo AJ, Sher ME, Cohen JR (1994) Surgical patients with pseudomembranous colitis: factors affecting prognosis. Surgery 116:768–775PubMedGoogle Scholar
  12. 12.
    Crabtree TD, Pelletier SJ, Gleason TG, Pruett TL, Sawyer RG (1999) Clinical characteristics and antibiotic utilization in surgical patients with Clostridium difficile-associated diarrhea. Am Surg 65:507–511PubMedGoogle Scholar
  13. 13.
    Grube BJ, Heimbach DM, Marvin JA (1987). Clostridium difficile diarrhoea in critically-ill burned patients. Arch Surg 122:655–661PubMedGoogle Scholar
  14. 14.
    Kreisel D, Savel TG, Silver AL, Cunningham JD (1995) Surgical antibiotic prophylaxis and Clostridium difficile toxin positivity. Arch Surg 130:989–993PubMedGoogle Scholar
  15. 15.
    Thibault A, Miller M, Gaese C (1991) Risk factors for the development of Clostridium difficile-associated diarrhea during a hospital outbreak. Infect Control Hosp Epidemiol 12:345–348PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryKing's College HospitalLondonUK

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