Incidence, risk factors, and outcome of Clostridioides difficile infection following urological surgeries

• Published in: World journal of urology 2021-08, Vol.39 (8), p.2995-3003
• Main Authors: Nguyen, Kevin A., Le, Danny Q., Bui, Yvonne T., Advani, Sonali D., Renzulli, Joseph, Kenney, Patrick A., Leapman, Michael S.
• Format: Article
• Language: English
• Subjects: Blood transfusion; Clostridioides difficile; Clostridium Infections - diagnosis; Clostridium Infections - drug therapy; Clostridium Infections - epidemiology; Clostridium Infections - etiology; Cross Infection - diagnosis; Cross Infection - drug therapy; Cross Infection - epidemiology; Cross Infection - etiology; Cystectomy - adverse effects; Cystectomy - methods; Diarrhea; Female; Hospitals; Humans; Incidence; Length of stay; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Oncology; Original; Original Article; Patients; Postoperative Complications - drug therapy; Postoperative Complications - epidemiology; Postoperative Complications - microbiology; Public health; Quality control; Renal failure; Reoperation - statistics & numerical data; Risk Assessment - statistics & numerical data; Risk Factors; Surgery; United States - epidemiology; Urinary Diversion - adverse effects; Urinary Diversion - methods; Urologic Surgical Procedures - adverse effects; Urologic Surgical Procedures - classification; Urologic Surgical Procedures - methods; Urology
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-020-03551-y

Purpose To assess the incidence, risk factors, and clinical outcomes associated with ( Clostridioides difficile infection) CDI following urological surgery, which is the leading cause of nosocomial diarrhea and a growing public health burden. Methods We queried the National Surgical Quality Improvement Program (NSQIP) to identify patients undergoing urological surgery in 2015–2016. We evaluated the 30-day incidence and factors associated with postoperative CDI and 30-day hospital readmission and length of stay as secondary outcomes. Among the subset of patients undergoing radical cystectomy with urinary diversion (surgery with highest CDI incidence) we used multivariable logistic regression analysis to evaluate independent clinical and demographic factors associated with postoperative CDI. Results We identified 98,463 patients during the study period. The overall 30-day incidence of CDI was 0.31%, but varied considerably across surgery type. The risk of CDI was greatest following radical cystectomy with urinary diversion (2.72%) compared to all other urologic procedures (0.19%) and was associated with increased risk of hospital readmission ( p