Evaluation of Risk Factors for a Fulminant Clostridium Difficile Infection After Cardiac Surgery

A Single-center, Retrospective Cohort Study

Maximilian Vondran; Senta Schack; Jens Garbade; Christian Binner; Meinhard Mende; Ardawan Julian Rastan; Michael Andrew Borger; Thomas Schroeter


BMC Anesthesiol. 2018;18(133) 

In This Article


In the present study we were able to detect independent risk factors for the development of a fulminant CDI. It is striking that the multivariate predictors would all appear to have a negative effect on the immune system or in some way to lower immune system defenses via stress on the patient's body. The severity of the course of CDI, in our view, depends on the vulnerability of the immune system and the stimuli that compromise it. A disturbance of the intestinal physiology and thus the microbial intestinal flora, e.g. by gastrointestinal diseases, surgical interventions, or antibiotic treatment, plays the biggest role here. Since preventive screening or prophylactic therapies are not useful, high-risk patients can be selected and targeted for close monitoring and an early intervention to avoid a fulminant course of an infection. By providing knowledge about peri-operative risk factors, this work can be a step towards the establishment of consistent risk stratification systems. Until new and effective treatment concepts are established, the selection of particularly vulnerable patients and their targeted observation is a way to control fulminant CDI of nosocomial origin.