title: Clostridium difficile infection in obstetric and gynecologic patients.
abstract: We reviewed hospital records of women on the obstetrics and gynecologic services with a diagnosis of antibiotic-associated diarrhea, pseudomembranous colitis, or Clostridium difficile infection to better characterize the incidence and course of women with C difficile infection. Cases were included if there was identification of C difficile by culture or toxin or endoscopic verification of pseudomembranous colitis. Between January 1985 and June 1995, there were 74,120 admissions to the obstetrics and gynecology services at two tertiary level hospitals. Eighteen women were found to have documented C difficile infection (0.02%)--3 from the obstetric services, 10 from the benign gynecologic services, and 5 from the gynecologic/oncology services. Diarrhea developed from 2 days to 30 days after antibiotics had been given (mean, 10 days). Nine patients had fever, six had nausea and vomiting, and five had abdominal pain. Antimicrobial agents given before infection included cephalexin, cefoxitin, imipenem, ciprofloxacin, trimethoprim/sulfamethoxazole, ampicillin, gentamicin, and clindamycin. All patients were treated successfully with inpatient antimicrobial agents-15 with metronidazole and 3 with vancomycin. There was one possible recurrence.
authors.affiliation: Department of Obstetrics/Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
authors.forename: A H
authors.initials: AH
authors.lastname: James
authors.forename: V L
authors.initials: VL
authors.lastname: Katz
authors.forename: D J
authors.initials: DJ
authors.lastname: Dotters
authors.forename: R G
authors.initials: RG
authors.lastname: Rogers
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000667:Ampicillin / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001427:Bacterial Toxins / Q000032:analysis; D002440:Cefoxitin / Q000009:adverse effects; D002506:Cephalexin / Q000009:adverse effects; D002511:Cephalosporins / Q000009:adverse effects; D002513:Cephamycins / Q000009:adverse effects; D002939:Ciprofloxacin / Q000009:adverse effects; D002981:Clindamycin / Q000009:adverse effects; D016360:Clostridioides difficile; D003113:Colonoscopy; D003967:Diarrhea / Q000209:etiology / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000209:etiology*; D005260:Female; D005334:Fever / Q000209:etiology; D005839:Gentamicins / Q000009:adverse effects; D006801:Humans; D015378:Imipenem / Q000009:adverse effects; D015994:Incidence; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010406:Penicillins / Q000009:adverse effects; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012189:Retrospective Studies; D013845:Thienamycins / Q000009:adverse effects; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects; D014839:Vomiting / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D002511:Cephalosporins; D002513:Cephamycins; D005839:Gentamicins; D010406:Penicillins; D013845:Thienamycins; D002981:Clindamycin; D002939:Ciprofloxacin; D002440:Cefoxitin; D015378:Imipenem; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D002506:Cephalexin