<i>Clostridium difficile</i> Infections in an Emergency Surgical Unit from North-East Romania
Bogdan Mihnea Ciuntu,
Gheorghe G. Balan,
Mihaela Buna-Arvinte,
Irina Mihaela Abdulan,
Adelina Papancea,
Ștefan Lucian Toma,
Bogdan Veliceasa,
Oana Viola Bădulescu,
Gabriela Ghiga,
Ana Maria Fătu,
Mihai Bogdan Vascu,
Antonia Moldovanu,
Dan Vintilă,
Alin Mihai Vasilescu
Affiliations
Bogdan Mihnea Ciuntu
Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street, No. 16, 700115 Iasi, Romania
Gheorghe G. Balan
Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street, No. 16, 700115 Iasi, Romania
Mihaela Buna-Arvinte
Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street, No. 16, 700115 Iasi, Romania
Irina Mihaela Abdulan
Department of Medical Specialties I, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Adelina Papancea
Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street, No. 16, 700115 Iasi, Romania
Ștefan Lucian Toma
Department of Materials Engineering and Industrial Security, Faculty of Materials Science and Engineering, Gheorghe Asachi Technical University of Iasi, 700050 Iasi, Romania
Bogdan Veliceasa
Department of Traumatology and Orthopaedics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Oana Viola Bădulescu
Department of Haematholohy, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Gabriela Ghiga
Department of Mother and Child Medicine, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Ana Maria Fătu
Department of Implantology Removable Denture Technology, Discipline of Ergonomy, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Mihai Bogdan Vascu
Department of Odontology, Periodontology and Fixed Prosthesis, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Antonia Moldovanu
Department of Odontology, Periodontology and Fixed Prosthesis, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
Dan Vintilă
Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street, No. 16, 700115 Iasi, Romania
Alin Mihai Vasilescu
Department of General Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, Universitatii Street, No. 16, 700115 Iasi, Romania
Background and Objectives: Colitis with Clostridium difficile is an important health problem that occurs with an intensity that varies between mild and severe. Surgical interventions are required only in fulminant forms. There is little evidence regarding the best surgical intervention in these cases. Materials and Methods: Patients with C. difficile infection were identified from the two surgery clinics from the ‘Saint Spiridon’ Emergency Hospital Iași, Romania. Data regarding the presentation, indication for surgery, antibiotic therapy, type of toxins, and post-operative outcomes were collected over a 3-year period. Results: From a total of 12,432 patients admitted for emergency or elective surgery, 140 (1.12%) were diagnosed with C. difficile infection. The mortality rate was 14% (20 cases). Non-survivors had higher rates of lower-limb amputations, bowel resections, hepatectomy, and splenectomy. Additional surgery was necessary in 2.8% of cases because of the complications of C. difficile colitis. In three cases, terminal colostomy was performed and as well as one case with subtotal colectomy with ileostomy. All patients who required the second surgery died within the 30-day mortality period. Conclusions: In our prospective study, the incidence was increased both in cases of patients with interventions on the colon and in those requiring limb amputations. Surgical interventions are rarely required in patients with C. difficile colitis.
