Clostridium Difficile Infection in Rectal Cancer Patients after Diverted Loop Ileostomy Closure

Aim: Clostridium difficile infection is a cause of increased morbidity and mortality in hospitals, particularly in patients with cancer pathology. There are several factors favouring the development of infection among cancer patients, including age, exposure to antibiotic and proton pump inhibitors therapy, and chemotherapy. This study was conducted to observe the prevalence of infection after the reversal of ileostomy loop for rectal cancer surgery, which were initially operated either open or laparoscopic. Method:A retrospective study was performed on patients who were operated in a single surgical team for rectal cancer who benefited of a diverted loop ileostomy over a 4-year period. Clostridium difficile: 23 patients were documented with infection out of a total of 63. All 23 patients underwent ileostomy closure later than 3 months after primary surgery, and post- operatively received antibiotic therapy associated with proton pump inhibitors in the first 24 hours. Conclusions: Closure of ileostomy later than 3 months after primary surgery, combined with chemotherapy, antibiotic therapy and proton pump inhibitors, increases the risk of developing infection.