Kirkwood KA, et al. - Researchers aimed at describing the incidence and risks of Clostridium difficile infections in cardiac surgery patients. They noticed C. difficile infection in nearly 1% of patients in this large multi-center prospective study. This infection was frequently diagnosed post-discharge, extended length of stay, and substantially increased mortality. Findings suggested an increased risk of C. difficile infection in patients with comorbidities, longer surgery time, extended antibiotic exposure and/or hyperglycemic episodes.

Methods

• In a prospective study of major infections after cardiac surgery, a total of 5,158 patients at 10 Cardiothoracic Surgical Trials Network sites in the US and Canada participated.
• Researchers followed the patients for infection, readmission, reoperation, or death up to 65 days after surgery.
• Patients with and without C. difficile infections were compared regarding clinical and demographic characteristics, surgical data, management practices, and outcomes.

Results

• As per observations, C. difficile was the third most common infection (0.97%) and was more common in patients with preoperative co-morbidities and complex operations.
• Antibiotic prophylaxis > 2 days, intensive care unit stay > 2 days, and postoperative hyperglycemia seemed correlated with higher risk of C. difficile infection.
• Median time to onset was 17 days; infections occurred post-discharge in 48%.
• In this study, additional length of stay due to infection was 12 days.
• In patients with C. difficile infection compared to uninfected patients, the readmission and mortality rates were three and five times higher respectively .