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World J Emerg Surg. 2019 Feb 28;14:8. doi: 10.1186/s13017-019-0228-3. eCollection 2019.

2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients.

Author information

1
Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata, Italy.
2
2Infectious Diseases Department, Trieste University Hospital, Trieste, Italy.
3
3Medicinal Chemistry, School of Pharmacy, University of Washington, Seattle, WA USA.
4
4Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN USA.
5
5Research School of Population Health, Australian National University, Acton, ACT Australia.
6
6Department of Microbiology, Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Khartoum, Sudan.
7
7Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
8
8Department of General Surgery, Bufalini Hospital, Cesena, Italy.
9
9Department of Surgery, University Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia.
10
10Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
11
11Department of General Surgery, Rambam Health Care Campus, Haifa, Israel.
12
12Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA USA.
13
13Pathology and Laboratory Medicine, VA Boston Healthcare System, West Roxbury MA and BU School of Medicine, Boston, MA USA.
14
Department of Internal Medicine, University Hospital, Dr. José E. González, Monterrey, Mexico.
15
15Department of Surgery, University of Santiago de Compostela, A Coruña, Spain.
16
16Department of General Surgery, Medway Maritime Hospital, Gillingham, Kent UK.
17
17Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, MI USA.
18
18Department of Surgery, West Virginia University Charleston Division, Charleston, WV USA.
19
19Faculty of Medicine, Transilvania University, Infectious Diseases Hospital, Brasov, Romania.
20
20Riverside University Health System Medical Center and Loma Linda University School of Medicine, Moreno Valley, CA USA.
21
Emergency Surgery Unit, San Filippo Neri's Hospital, Rome, Italy.
22
Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China.
23
23Department of Infectious Diseases, Jagiellonian University, Medical College, Kraków, Poland.
24
24Department of Surgery, Tbilisi State Medical University, Kipshidze Central University Hospital, Tbilisi, Georgia.
25
25Department of Surgical Sciences, Cannizzaro Hospital, University of Catania, Catania, Italy.
26
26Department of Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
27
27Clinical Infectious Diseases Hospital, Ovidius University, Constanta, Romania.
28
Department of General, Visceral and Thoracic Surgery, Klinikum Peine, Hospital of Medical University Hannover, Peine, Germany.
29
Vital Care, Inc, Meridian, MS USA.
30
30Department of Surgery, Stanford University, Stanford, CA USA.
31
31Division of Trauma Surgery, Hospital de Clinicas, School of Medical Sciences, University of Campinas, Campinas, Brazil.
32
32Service of Gastroenterology and Hepatology, Geneva University Hospital, Genève, Switzerland.
33
33Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL USA.
34
34University of New Mexico School of Medicine, Albuquerque, NM USA.
35
35Critical Care Unit, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain.
36
36Department of Surgery Mansoura, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
37
37Surgery Department, Hospital Universitario (HU) Terezinha de Jesus da Faculdade de Ciencias Medicas e da Saude de Juiz de Fora (SUPREMA), Hospital Universitario (HU) Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil.
38
38Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK.
39
Unit of Endocrine, Head, and Neck Surgery and Unit of Surgical Infections Support, Department of General Surgery, Parc Taulí, Hospital Universitari, Sabadell, Spain.
40
40Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire UK.
41
41Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
42
42Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
43
43Department of Gastroenterology, Queen Elizabeth Hospital, Birmingham, UK.
44
44General Surgery Department, Magee Womens Hospital, UPMC, Pittsburgh, USA.
45
45Department of Surgery, VA Boston Health Care System, Boston University and Harvard Medical School, Boston, MA USA.
46
Global Alliance for Infections in Surgery, Porto, Portugal.
47
47School of Medical Sciences, University Sains Malaysia, Kota Bharu, Kelantan Malaysia.
48
48Department of Pharmacy Practice, St Louis College of Pharmacy, St Louis, MO USA.
49
Faculty of Mediine University of Belgrade Clinic for Surgery "Nikola Spasic", University Clinical Center "Zvezdara" Belgrade, Belgrade, Serbia.
50
50Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY USA.
51
51Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland.
52
52Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
53
53Department of Surgery, Universidad Nacional de Asuncion, Asuncion, Paraguay.
54
54Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India.
55
55Department of Surgery, Washington University School of Medicine, Saint Louis, USA.
56
56Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
57
Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, CO USA.
58
58Department of Surgery, University of Florida, Gainesville, FL USA.
59
59Department of Surgery, Fundación Valle del Lili, Hospital Universitario del Valle, Universidad del Valle, Cali, Colombia.
60
Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy.
61
National Institute for Infectious Diseases - INMI - Lazzaro Spallanzani IRCCS, Rome, Italy.
62
62Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
63
Department of Surgery, Anadolu Medical Center, Kocaali, Turkey.
64
Department of Abdominal and General Surgery, General Hospital Jesenice, Jesenice, Slovenia.
65
65Department of Surgery, Medical University of Plovdiv, Plovdiv, Bulgaria.
66
66Division of Emergency Surgery, Department of Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
67
67Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
68
68Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
69
69Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France.
70
70First Department of Surgery, Faculty of Medicine, Masaryk University Brno and University Hospital of St. Ann Brno, Brno, Czech Republic.
71
71First Department of Surgery, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.
72
72Clinic of Infectious Diseases, St Orsola-Malpighi University Hospital, Bologna, Italy.
73
73Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
74
74Emergency Surgery Department, Maggiore Parma Hospital, Parma, Italy.

Abstract

In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.

KEYWORDS:

Antimicrobial stewardship; Antimicrobial treatment; Clostridioides difficile infection; Clostridium difficile infection; Fecal microbiota transplantation; Infection control; Pseudomembranous colitis

PMID:
30858872
PMCID:
PMC6394026
DOI:
10.1186/s13017-019-0228-3
[Indexed for MEDLINE]
Free PMC Article

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