The morbidity of C. difficile in necrotizing pancreatitis

Thomas K. Maatman, Jamaica A. Westfall-Snyder, Megan E. Nicolas, Elliott J. Yee, Eugene P. Ceppa, Michael G. House, Attila Nakeeb, C. Max Schmidt, Nicholas J. Zyromski

Research output: Contribution to journalArticle

1 Scopus citations


Introduction: Necrotizing pancreatitis (NP) patients commonly require antibiotic treatment during the several month-long disease course. We hypothesized that Clostridium difficile infection (CDI) is common in NP and significantly impacts outcomes. Materials and methods: Retrospective review of 704 NP patients treated at a single-institution (2005–2018). Results: 10% (67/704) of patients developed CDI a mean 78 days after NP onset. Patients developing CDI experienced increased total hospital days (CDI, 104; No CDI, 42; P < 0.001), readmission rates (CDI, 85%; No CDI, 64%; P = 0.006), and duration of NP (CDI, 248 days; No CDI, 183; P = 0.001). Risk factors for CDI included antibiotic use (OR, 96.2; 95% CI, 5.9–1556.2; P = 0.001) and any organ failure (OR, 2.0; 95% CI, 1.2–3.3, P = 0.008). Mortality was not affected by CDI (CDI, 10%; No CDI, 9%; P = 0.7). Conclusion: Clostridium difficile infection is common in necrotizing pancreatitis and negatively impacts morbidity and disease recovery.

Original languageEnglish (US)
Pages (from-to)509-512
Number of pages4
JournalAmerican Journal of Surgery
Issue number3
StatePublished - Mar 2020


  • Antibiotics
  • Clostridium difficile infection
  • Colitis
  • Infectious diarrhea
  • Necrotizing pancreatitis

ASJC Scopus subject areas

  • Surgery

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