CLOSTRIDIUM DIFFICILE INFECTION AFTER THE TREATMENT OF ACUTE PANCREATITIS

• Published in: Revista medicală Română Vol. 66; no. 4; pp. 363 - 369
• Main Authors: Iulia-Cristina Pîrvulescu, Mihnea Avram, Sorin Păun, Mircea Beuran, Eduard Cristian Popa, Bogdan Stoica, Alexandru Laurenţiu Chiotoroiu, Bogdan Gaspar
• Format: Journal Article
• Language: English
• Published: Amaltea Medical Publishing House 01.12.2019
• Subjects: acute pancreatitis; antibiotherapy; clostridium difficile; pancreas
• ISSN: 1220-5478; 2069-606X
• DOI: 10.37897/RMJ.2019.4.13

Clostridium infection has become a common healthcare-associated infection over the past few years. The faulty management of prophylactic antibiotherapy, despite the existence of management protocols has contributed to the increase on antibiotic resistant pattern. The retrospective study included a number of 19 patients (1.48%) diagnosticated with Clostridium infection, out of a total of 1,283 patients with acute pancreatitis admitted into the General Surgery Ward of the Clinical Emergency Hospital in Bucharest, between January 2015 and December 2018. Out of a total of 1,283 cases of acute pancreatitis, only 19 patients (1.48%) were tested positive (stool test for Clostridium difficile toxine a/b).The presence of toxin a/b in the stool was identified in average on the 13th day after admission and the samples came back negative in 7 cases (36.8%) prior to the discharge, 9 patients requested to be discharged without being tested negative after treatment (42.2%) and 6 deaths were reported (31.5%). 13 patients previously received broad spectrum antibiotherapy (68.4%), 3 patients had a history of at least one episode of acute pancreatitis. 5 patients received antibiotherapy with sole vancomycin (26.3%), 3 sole with metronidazole (15.8%) and 11 patients received vancomycin and metronidazole (57.9%). Three cases were reported as hospital-acquired infection (15.7%). Conclusion. Clostridium difficile infection represents an aggravating factor of acute pancreatitis that requires both fast diagnosis, as well as adequate treatment.