Review Article| Volume 36, ISSUE 4, P889-895, December 2022

Download started.


Severe Clostridioides difficile Infection in the Intensive Care Unit—Medical and Surgical Management


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.


      Subscribe to Infectious Disease Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kyne L.
        • Hamel M.B.
        • Polavaram R.
        • et al.
        Health care costs and mortality associated with nosocomial diarrhea due to Clostridium difficile.
        Clin Infect Dis. 2002; 34: 346-353
        • Lawrence S.J.
        • Puzniak L.A.
        • Shadel B.N.
        • et al.
        Clostridium difficile in the intensive care unit: epidemiology, costs, and colonization pressure.
        Infect Control Hosp Epidemiol. 2007; 28: 123-130
        • Johnson S.
        • Lavergne V.
        • Skinner A.M.
        • et al.
        Clinical practice guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 focused update guidelines on management of Clostridioides difficile infection in adults.
        Clin Infect Dis. 2021; : ciab549
        • Scaria E.
        • Barker A.K.
        • Alagoz O.
        • et al.
        Association of Visitor Contact Precautions with Estimated Hospital-Onset Clostridioides difficile Infection Rates in Acute Care Hospitals.
        JAMA Netw Open. 2021; 4: e210361
        • Louh I.K.
        • Greendyke W.G.
        • Hermann E.A.
        • et al.
        Clostridium difficile infection in acute care hospitals: Systematic review and best practices for prevention.
        Infect Control Hosp Epidemiol. 2017; 38: 476-482
        • Kelly C.P.
        • LaMont J.T.
        Clostridium difficile – more difficult than ever.
        N Engl J Med. 2008; 359: 1932-1940
        • Cornely O.A.
        • Miller M.A.
        • Louie T.J.
        • et al.
        Treatment of First Recurrence of Clostridium difficile Infection: Fidaxomicin Versus Vancomycin.
        Clin Infect Dis. 2012; 55
        • Crook D.W.
        • Walker A.S.
        • Kean Y.
        • et al.
        Fidaxomicin Versus Vancomycin for Clostridium difficile Infection: Meta-Analysis of Pivotal Randomized Controlled Trials.
        Clin Infect Dis. 2012; 55: S93-S103
        • Ballard T.E.
        • Wang X.
        • Olekhnovich I.
        • et al.
        Biological Activity of Modified and Exchanged 2-Amino-5-Nitrothiazole Amide Analogues of Nitazoxanide.
        Bioorg Med Chem Lett. 2010; 20: 3537-3539
        • Wilcox M.H.
        • Gerdin D.N.
        • Poxton I.R.
        • et al.
        Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection.
        N Engl J Med. 2017; 376: 305-317
        • Goldenberg J.Z.
        • Ma S.S.
        • Saxton J.D.
        • et al.
        Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children.
        Cochrane Database Syst Rev. 2013; (PMID:23728658): CD006095
        • Tariq R.
        • Laguio-Vila M.
        • Tahir M.W.
        • et al.
        Efficacy of oral vancomycin prophylaxis for prevention of Clostridioides difficile infection: a systematic review and meta-analysis.
        Therap Adv Gastroenterol. 2021; 14 (1756284821994046)
        • Seder C.W.
        • et al.
        Early colectomy may be associated with improved survival in fulminant Clostridium difficile colitis: an 8-year experience.
        The Am J Surg. 2009; 197: 302-307
        • Dallal Ramsey M.
        • Harbrecht Brian G.
        • Boujoukas Arthur J.
        • et al.
        Fulminant Clostridium difficile: an underappreciated and increasing cause of death and complications.
        Ann Surg. 2002; 235: 363-372
        • Sartelli Massimo
        • Di Bella Stefano
        • McFarland Lynne V.
        • et al.
        2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients.
        World J Emerg Surg. 2019; 14: 1-29
        • Ferrada Paula
        • Velopulos Catherine G.
        • Sultan Shahnaz
        • et al.
        Timing and type of surgical treatment of Clostridium difficile–associated disease: a practice management guideline from the Eastern Association for the Surgery of Trauma.
        J Trauma Acute Care Surg. 2014; 76: 1484-1493
        • Kim Min Jeong
        • Kim Byung Seup
        • Kwon Jae Woo
        • et al.
        Risk factors for the development of Clostridium difficile colitis in a surgical ward.
        J Korean Surg Soc. 2012; 83: 14-20
        • Wijarnpreecha Karn
        • Sornprom Suthanya
        • Thongprayoon Charat
        • et al.
        Nasogastric tube and outcomes of Clostridium difficile infection: A systematic review and meta-analysis.
        J Evidence-Based Med. 2018; 11: 40-45
        • Zerey Marc
        • Paton Lauren B.
        • Lincourt Amy E.
        • et al.
        The burden of Clostridium difficile in surgical patients in the United States.
        Surg infections. 2007; 8: 557-566
        • Skancke Matthew
        • Vaziri Khashayar
        • Umapathi Bindu
        • et al.
        Elective stoma reversal has a higher incidence of postoperative Clostridium difficile infection compared with elective colectomy: an analysis using the American College of Surgeons National Surgical Quality Improvement Program and targeted colectomy databases.
        Dis Colon Rectum. 2018; 61: 593-598
        • Khanna Sahil
        • Baddour Larry M.
        • Dibaise John K.
        • et al.
        Appendectomy Is Not Associated with Adverse Outcomes inClostridium difficile Infection: A Population-Based Study.
        Official J Am Coll Gastroenterol ACG. 2013; 108: 626-627
        • Jaber Raffat M.
        • Olafsson Snorri
        • Fung Wesley L.
        • et al.
        Clinical review of the management of fulminant Clostridium difficile infection.
        Official J Am Coll Gastroenterol ACG. 2008; 103: 3195-3203
        • Revzin Margarita V.
        • Moshiri Mariam
        • Bokhari Jamal
        • et al.
        Sonographic assessment of infectious diseases of the gastrointestinal tract: from scanning to diagnosis.
        Abdom Radiol. 2020; 45: 261-292
        • Abu-Zidan Fikri M.
        • Arif Alper Cevik
        Diagnostic point-of-care ultrasound (POCUS) for gastrointestinal pathology: state of the art from basics to advanced.
        World J Emerg Surg. 2018; 13: 1-14
        • Miller Mark A.
        • Louie Thomas
        • Mullane Kathleen
        • et al.
        Derivation and validation of a simple clinical bedside score (ATLAS) for Clostridium difficile infection which predicts response to therapy.
        BMC Infect Dis. 2013; 13: 1-7
        • Van Der Wilden Gwendolyn M.
        • Chang Yuchiao
        • Cropano Catrina
        • et al.
        Fulminant Clostridium difficile colitis: prospective development of a risk scoring system.
        J Trauma Acute Care Surg. 2014; 76: 424-430
        • Halabi Wissam J.
        • Nguyen Vinh Q.
        • Carmichael Joseph C.
        • et al.
        Clostridium difficile colitis in the United States: a decade of trends, outcomes, risk factors for colectomy, and mortality after colectomy.
        J Am Coll Surg. 2013; 217: 802-812
        • Neal Matthew D.
        • Alverdy John C.
        • Hall Daniel E.
        • et al.
        Diverting loop ileostomy and colonic lavage: an alternative to total abdominal colectomy for the treatment of severe, complicated Clostridium difficile associated disease.
        Ann Surg. 2011; 254: 423-429
        • Jarrad A.M.
        • Karoli T.
        • Blaskovich M.A.
        • et al.
        Clostridium difficile Drug Pipeline: Challenges in Discovery and Development of New Agents.
        J Med Chem. 2015; 58: 5164-5185