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Original article UDC: 616.345-002-089:579.86 doi:10.5633/amm.2015.0113
Clostridium difficile colitis - a role of surgery
Ladislav Mitáš1, Tomáš Skřička1, Zdeněk
Kala1, Pavel Polák2, Igor Penka1,
Surgical Clinic of University Hospital Brno and Faculty of Medicine,
Masaryk University Brno, Czech Republic1
Clinic of Infectious Diseases of University Hospital Brno and Faculty of Medicine,
Masaryk University Brno, Czech Republic2
Department of Clinical Microbiology of University Hospital Brno and Faculty of Medicine,
Masaryk University Brno, Czech Republic3
Contact: Tomas Skricka
Clostridium difficile infection (CDI) is the most frequent cause of nococomial diarrhoea. Most cases are succesfully treated by antibiotic therapy, but nearly 10% may progress to the fulminant form. The aim of this work is a retrospective evaluation of the results of surgical treatment of patients with the severe Costridium colitis, in the period 2008-2014.
Clostridium toxins were detected in patients in Bohunice University Hospital in 1956. Thirty seven of them underwent surgery due to toxic colitis. There were 6 total colectomies with terminal ileostomy, 29 subtotal colectomies with terminal ileostomy, 1 coecostomy and 1 axial ileostomy. The 30-day mortality was nearly 35 %, 90- day mortality 54% and morbidity 89%.
Early and precise indication for surgery could save about 65% of patients with fulminant course of Clostridium difficile colitis. Acta Medica Medianae 2015;54(1):75-80.
Key words: Clostridium difficile colitis, toxic colitis, surgery