Clostridium difficile: What the surgeon needs to know

Clostridium difficile infection (CDI) is a common nosocomial infection that all medical practitioners must be familiar with, as all patients are at risk of developing this infectious disease. Although it has long been appreciated that this infectious disease arises secondary to the development of a colonic dysbiosis, as our understanding of the microbiome has grown substantially broader, the utilization of fecal microbiota therapy for this disease has also become a widespread reality. In addition to understanding the role of the microbiome in CDI, the poor prognosis of patients with severe, complicated CDI must also be recognized by critical care providers and abdominal surgeons. Strategies to lower the threshold for surgical consultation, and guidelines to help decide when surgery is indicated, can decrease mortality for patients. This chapter reviews these issues, as well as other aspects relevant to the treatment and care of patients with CDI.