2019 Volume 16 Issue 3 Pages 185-191
【Background】 The incidence of Clostridioides difficile infection (CDI) after orthopedic surgery is generally low. But, once they get infected, their risk of death will be high, and will increase length of stay and medical costs. 【Patients and Methods】 We explored cases that developed postoperative CDI among patients who received orthopedic surgery at our hospital from April 2016 to March 2019. 【Results】 Four cases (0.071％) developed CDI among 5,619 patients who received orthopedic surgery. All CDI patients received cefazolin as their antimicrobial prophylaxis (AMP), and only 1 patient received prolonged administration of 19 days. Two received additional antibiotics after surgery, three had multiple co-morbidities, and two were hospitalized before surgery for more than 11 days. All patients received oral metronidazole (MNZ) for treatment, but 1 case required intravenous MNZ with oral vancomycin (VCM) as there was no improvement. 【Discussion】 Age, comorbidity, length of stay before surgery, and administration of multiple antibiotics and prolonged duration are the risk factors of CDI in orthopedic surgery. These factors may have influenced the onset of CDIs. AMP is one of the CDI risk factor which can be modified easily, and its adequate use may also improve CDI risk. We believe it is important not to administer AMP too long, especially in institutions with high CDI incidence.
