Clostridium difficile infection is the most common hospital-acquired infection and a significant cause of increased hospital stay and cost for patients and payors alike. In the May issue of Diseases of the Colon & Rectum, surgeons from George Washington University Hospital sought to identify rates of C. difficile infection in patients undergoing common types of colon operations. These included both elective colon resection as well as closure of temporary stomas. In order to do this, the authors utilized the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) and targeted colectomy database for 2015. They identified over 2200 patients who had undergone elective stoma reversal and over 10,000 patients who had undergone elective colon resection. Patients undergoing stoma reversal had a significantly higher rate of C. difficile infection in the first 30 postoperative day period than those undergoing colon resection (3.04% versus 1.25%, respectively). The authors identified that stoma reversal, smoking, steroid use, and disseminated cancer were all associated with a higher rate of postoperative C. difficile infection.
Author Matthew Skancke said: “We believe that our data presents compelling evidence of the increased incidence of postoperative Clostridium difficile in patients following ileostomy or colostomy reversal.”