Acta Chir Orthop Traumatol Cech. 2022; 89(5):376-379 | DOI: 10.55095/achot2022/060

Clostridium difficile Colitis in Patients Undergoing Surgery for Adolescent Idiopathic ScoliosisOriginal papers

A. JURBAN, Y. ANEKSTEIN, Y. MORDISH, O. RABAU, Y. MIROVSKY, Y. SMORGICK*
Department of Orthopedic Surgery and the Spine Unit and the Department of Pediatrics, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

PURPOSE OF THE STUDY:
To identify risk factors associated with developing Clostridium difficile infection (CDI) in adolescent idiopathic scoliosis patients after surgery and to describe the clinical presentation of CDI in these patients.
Clostridium difficile colitis is reportedly increasing in hospitalized patients and can have a negative impact on patient outcomes. No data exist on CDI rates and its consequences on patient undergoing surgery for adolescent idiopathic scoliosis.

MATERIAL AND METHODS:
A retrospective database review of patients who underwent elective idiopathic scoliosis surgery between January 2019 to June 2021 was conducted. The population was divided into patients who developed Clostridium difficile colitis and those who did not.

RESULTS:
A total of 128 patients were included in the study. We did not find notable risk factors for the development of CDI. In 2 patients diagnosis of CDI, was made. Length of hospital stays, and readmissions were significantly higher in patients with CDI.

CONCLUSIONS:
CDI is a rare post-surgical complication in patients who undergo surgery for idiopathic scoliosis. Currently, we cannot identify predisposing factors for the development of CDI in adolescent idiopathic scoliosis patients.
A high index of suspicion is necessary for timely diagnosis and treatment in patients presenting with abdominal symptoms around post-operative day 5 after surgical treatment for idiopathic scoliosis.

Keywords: Clostridium difficile infection, adolescent idiopathic scoliosis, abdominal pain, diarrhea

Published: October 15, 2022  Show citation

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JURBAN A, ANEKSTEIN Y, MORDISH Y, RABAU O, MIROVSKY Y, SMORGICK Y. Clostridium difficile Colitis in Patients Undergoing Surgery for Adolescent Idiopathic Scoliosis. Acta Chir Orthop Traumatol Cech. 2022;89(5):376-379. doi: 10.55095/achot2022/060. PubMed PMID: 36322039.
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References

  1. Bell J, Vatani J, Raad M, Labaran L, Puvanesarajah V, Hassanzadeh H. Clostridium difficile Infection following spine surgery: incidence, risk factors, and association with preoperative antibiotic use. Spine (Phila Pa 1976). 2020;45:1572-1579. doi: 10.1097/BRS.0000000000003627. PMID: 32756273. Go to original source... Go to PubMed...
  2. Bovonratwet P, Bohl DD, Russo GS, Ondeck NT, Singh K, Grauer JN. Incidence, risk factors, and impact of Clostridium difficile colitis after spine surgery: an analysis of a national database. Spine. 2018;43:861-868. Go to original source... Go to PubMed...
  3. Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA; American Society of Health-System Pharmacists; Infectious Disease Society of America; Surgical Infection Society; Society for Healthcare Epidemiology of America. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70:195-283. Go to original source... Go to PubMed...
  4. Crobach MJ, Planche T, Eckert C, Barbut F, Terveer EM, Dekkers OM, Wilcox MH, Kuijper EJ. European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection. Clin Microbiol Infect. 2016;22(Suppl 4):S63-S81. Go to original source... Go to PubMed...
  5. Guzman JZ, Skovrlj B, Rothenberg ES, Lu Y, McAnany S, Cho SK, Hecht AC, Qureshi SA. The burden of Clostridium difficile after cervical spine surgery. Global Spine J. 2016;6:314-321. Go to original source... Go to PubMed...
  6. Kim DY, Lee Y-M, Kim YJ, Lee M, Lee HJ, Park KH. Prevalence, risk factors, and outcome of postoperative Clostridium difficile infection after orthopedic surgery. Open Forum Infect Dis. 2018;5(Suppl 1):S176. Go to original source...
  7. Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, Blanke K. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001;83-A:1169-1181. Go to original source...
  8. McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Shaklee Sammons J, Sandora TJ, Wilcox MH. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66:e1-48. Go to original source... Go to PubMed...
  9. Osebold WR, Cohen AN, Gillum MD, Hurley JH, Locher NJ. Postoperative Clostridium difficile pseudomembranous colitis in idiopathic scoliosis. A brief clinical report. Spine (Phila Pa 1976). 1993;18:2549-2552. doi: 10.1097/00007632-199312000-00031. Go to original source... Go to PubMed...
  10. Sammons JS, Toltzis P, Zaoutis TE. Clostridium difficile infection in children. JAMA Pediatr. 2013;167:567-573. Go to original source... Go to PubMed...
  11. Skovrlj B, Guzman JZ, Silvestre J, Al Maaieh M, Qureshi SA. Clostridium difficile colitis in patients undergoing lumbar spine surgery. Spine. 2014;39: E1167-1173. Go to original source... Go to PubMed...
  12. Welling SE, Katz CB, Goldberg MJ, Bauer JM. NSQIP versus institutional morbidity and mortality conference: complementary complication reporting in pediatric spine fusion. Spine Deform. 2021;9:113-118. doi: 10.1007/s43390-020-00197-z. Epub 2020. Go to original source... Go to PubMed...