title: WSES guidelines for management of Clostridium difficile infection in surgical patients.
abstract: In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.
authors: Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62019 Macerata, Italy.
authors: Massimo
authors: M
authors: Sartelli
authors: American Board of Surgery, Philadelphia, USA.
authors: Mark A
authors: MA
authors: Malangoni
authors: Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
authors: Fikri M
authors: FM
authors: Abu-Zidan
authors: Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK.
authors: Ewen A
authors: EA
authors: Griffiths
authors: 2nd Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
authors: Stefano
authors: S
authors: Di Bella
authors: Department of Medicinal Chemistry, School of Pharmacy, University of Washington, Washington, USA.
authors: Lynne V
authors: LV
authors: McFarland
authors: Department of Medical Microbiology, King's College Hospital, London, UK.
authors: Ian
authors: I
authors: Eltringham
authors: Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
authors: Vishal G
authors: VG
authors: Shelat
authors: Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA.
authors: George C
authors: GC
authors: Velmahos
authors: Gastroenterology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA.
authors: Ciarán P
authors: CP
authors: Kelly
authors: Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN USA.
authors: Sahil
authors: S
authors: Khanna
authors: Department of Surgery, University of Michigan, Ann Arbor, MI USA.
authors: Zaid M
authors: ZM
authors: Abdelsattar
authors: Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI USA.
authors: Layan
authors: L
authors: Alrahmani
authors: General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors: Luca
authors: L
authors: Ansaloni
authors: Department of Surgery, University Hospital Center Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia.
authors: Goran
authors: G
authors: Augustin
authors: Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors: Miklosh
authors: M
authors: Bala
authors: UHLIN (Unité d'Hygiène et de Lutte contre les Infections Nosocomiales) National Reference Laboratory for Clostridium difficile Groupe Hospitalier de l'Est Parisien (HUEP), Paris, France.
authors: Frédéric
authors: F
authors: Barbut
authors: Department of General Surgery, Rambam Health Care Campus, Haifa, Israel.
authors: Offir
authors: O
authors: Ben-Ishay
authors: Academic Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
authors: Aneel
authors: A
authors: Bhangu
authors: Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, USA.
authors: Walter L
authors: WL
authors: Biffl
authors: Pathology and Laboratory Medicine, VA Boston Healthcare System, West Roxbury MA and BU School of Medicine, Boston, MA USA.
authors: Stephen M
authors: SM
authors: Brecher
authors: Department of Internal Medicine, University Hospital, Dr.José E. González, Monterrey, Mexico.
authors: Adrián
authors: A
authors: Camacho-Ortiz
authors: Department of Surgery, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors: Miguel A
authors: MA
authors: Caínzos
authors: Department of Pathology, University of Alberta Edmonton, Edmonton, AB Canada.
authors: Laura A
authors: LA
authors: Canterbury
authors: Emergency Surgery Department, Maggiore Parma Hospital, Parma, Italy.
authors: Fausto
authors: F
authors: Catena
authors: Department of General Surgery, Medway Maritime Hospital, Gillingham Kent, UK.
authors: Shirley
authors: S
authors: Chan
authors: Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, MI USA.
authors: Jill R
authors: JR
authors: Cherry-Bukowiec
authors: Department of Surgery, Northeast Ohio Medical University, Summa Akron City Hospital, Akron, OH USA.
authors: Jesse
authors: J
authors: Clanton
authors: General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors: Federico
authors: F
authors: Coccolini
authors: Faculty of Medicine, Transilvania University, Infectious Diseases Hospital, Brasov, Romania.
authors: Maria Elena
authors: ME
authors: Cocuz
authors: Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, University of California San Diego Health Science, San Diego, USA.
authors: Raul
authors: R
authors: Coimbra
authors: Division of Acute Care Surgery, Trauma and Surgical Critical Care, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA USA.
authors: Charles H
authors: CH
authors: Cook
authors: Department of Surgery,Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China.
authors: Yunfeng
authors: Y
authors: Cui
authors: Department of Infectious Diseases, Jagiellonian University, Medical College, Kraków, Poland.
authors: Jacek
authors: J
authors: Czepiel
authors: Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.
authors: Koray
authors: K
authors: Das
authors: Department of Surgery, Tbilisi State Medical University, Kipshidze Central University Hospital, Tbilisi, Georgia.
authors: Zaza
authors: Z
authors: Demetrashvili
authors: Department of Surgery, Hamad General Hospital, Doha, Qatar.
authors: Isidoro
authors: I
authors: Di Carlo
authors: Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy.
authors: Salomone
authors: S
authors: Di Saverio
authors: Clinical Infectious Diseases Hospital, Ovidius University, Constanta, Romania.
authors: Irina Magdalena
authors: IM
authors: Dumitru
authors: National Reference Laboratory for Clostridium difficile, AP-HP, Saint-Antoine Hospital, Paris, France.
authors: Catherine
authors: C
authors: Eckert
authors: Department of General, Visceral and Thoracic Surgery, Klinikum Peine, Hospital of Medical University Hannover, Peine, Germany.
authors: Christian
authors: C
authors: Eckmann
authors: Vital Care, Inc, Meridian, MS USA.
authors: Edward H
authors: EH
authors: Eiland
authors: Department of Medicine, Section of Infectious Diseases, King Fahad Medical City, Riyadh, Saudi Arabia.
authors: Mushira Abdulaziz
authors: MA
authors: Enani
authors: Department of General Surgery, Trauma and Emergency Surgery Division, ABC Medical School, Santo André, SP Brazil.
authors: Mario
authors: M
authors: Faro
authors: Division of Trauma, Critical Care and Emergency Surgery, Virginia Commonwealth University, Richmond, VA USA.
authors: Paula
authors: P
authors: Ferrada
authors: Department of Surgery, Stanford University, Stanford, CA USA.
authors: Joseph Derek
authors: JD
authors: Forrester
authors: Division of Trauma Surgery, Hospital de Clinicas, School of Medical Sciences, University of Campinas, Campinas, Brazil.
authors: Gustavo P
authors: GP
authors: Fraga
authors: Service of Gastroenterology and Hepatology, Geneva University Hospital, Genève, Switzerland.
authors: Jean Louis
authors: JL
authors: Frossard
authors: Critical Care Unit, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, Spain.
authors: Rita
authors: R
authors: Galeiras
authors: Department of Surgery Mansoura, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors: Wagih
authors: W
authors: Ghnnam
authors: Surgery Department, Hospital Universitario (HU) Terezinha de Jesus da Faculdade de Ciencias Medicas e da Saude de Juiz de Fora (SUPREMA), Hospital Universitario (HU) Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil.
authors: Carlos Augusto
authors: CA
authors: Gomes
authors: Department of Internal Medicine, Pinnacle Health Hospital, Harrisburg, PA USA.
authors: Venkata
authors: V
authors: Gorrepati
authors: Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire UK.
authors: Mohamed Hassan
authors: MH
authors: Ahmed
authors: Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
authors: Torsten
authors: T
authors: Herzog
authors: Department of Gastroenterology and Hepatology, Ochsner Clinic Foundation, New Orleans, LA USA.
authors: Felicia
authors: F
authors: Humphrey
authors: Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
authors: Jae Il
authors: JI
authors: Kim
authors: General Surgery Department, Erzincan University Mengücek Gazi Training and Research Hospital, Erzincan, Turkey.
authors: Arda
authors: A
authors: Isik
authors: Division of Trauma, Critical Care and Emergency Surgery, Virginia Commonwealth University, Richmond, VA USA.
authors: Rao
authors: R
authors: Ivatury
authors: School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan Malaysia.
authors: Yeong Yeh
authors: YY
authors: Lee
authors: Department of Pharmacy Practice, St Louis College of Pharmacy, St Louis, MO USA.
authors: Paul
authors: P
authors: Juang
authors: Research School of Population Health, The Australian National University, Acton, ACT Australia.
authors: Luis
authors: L
authors: Furuya-Kanamori
authors: Clinic For Emergency surgery, University Clinical Center of Serbia, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
authors: Aleksandar
authors: A
authors: Karamarkovic
authors: General and Trauma Surgery, Albert Einstein College of Medicine, North Bronx Healthcare Network, Bronx, NY USA.
authors: Peter K
authors: PK
authors: Kim
authors: Department of General Surgery, Rambam Health Care Campus, Haifa, Israel.
authors: Yoram
authors: Y
authors: Kluger
authors: Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors: Wen Chien
authors: WC
authors: Ko
authors: Department of Internal Medicine, Pinnacle Health Hospital, Harrisburg, PA USA.
authors: Francis D
authors: FD
authors: LaBarbera
authors: Division of Critical Care & Trauma Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
authors: Jae Gil
authors: JG
authors: Lee
authors: Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland.
authors: Ari
authors: A
authors: Leppaniemi
authors: Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors: Varut
authors: V
authors: Lohsiriwat
authors: Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India.
authors: Sanjay
authors: S
authors: Marwah
authors: Department of Surgery, Washington University School of Medicine, Saint Louis, USA.
authors: John E
authors: JE
authors: Mazuski
authors: Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors: Gokhan
authors: G
authors: Metan
authors: Department of Surgery, University of Colorado, Denver Health Medical Center, Denver, USA.
authors: Ernest E
authors: EE
authors: Moore
authors: Department of Surgery, University of Florida, Gainesville, FL USA.
authors: Frederick Alan
authors: FA
authors: Moore
authors: Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors: Carl Erik
authors: CE
authors: Nord
authors: Department of Surgery, Fundación Valle del Lili, Hospital Universitario del Valle, Universidad del Valle, Cali, Colombia.
authors: Carlos A
authors: CA
authors: Ordoñez
authors: Emergency Surgery and Trauma Unit, Department of Surgery, Ribeirão Preto, Brazil.
authors: Gerson Alves Pereira
authors: GA
authors: Júnior
authors: 2nd Infectious Diseases Division, National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.
authors: Nicola
authors: N
authors: Petrosillo
authors: Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors: Francisco
authors: F
authors: Portela
authors: Department of Medicine, Hammersmith Hospital and Imperial College London, London, UK.
authors: Basant K
authors: BK
authors: Puri
authors: Department of Gastroenterology and Hepatology, Ochsner Clinic Foundation, New Orleans, LA USA.
authors: Arnab
authors: A
authors: Ray
authors: Infectious Diseases and Microbiology Unit, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire UK.
authors: Mansoor
authors: M
authors: Raza
authors: Department of Abdominal and General Surgery, General Hospital Jesenice, Jesenice, Slovenia.
authors: Miran
authors: M
authors: Rems
authors: Department of Surgery, Medical University of Plovdiv, Plovdiv, Bulgaria.
authors: Boris E
authors: BE
authors: Sakakushev
authors: Division of General Surgery and Organ Transplantation, Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy.
authors: Gabriele
authors: G
authors: Sganga
authors: Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
authors: Patrizia
authors: P
authors: Spigaglia
authors: Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA USA.
authors: David B
authors: DB
authors: Stewart
authors: Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France.
authors: Pierre
authors: P
authors: Tattevin
authors: AP-HP Bichat hospital, Medical and infectious diseases ICU, Paris, France.
authors: Jean Francois
authors: JF
authors: Timsit
authors: Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, MI USA.
authors: Kathleen B
authors: KB
authors: To
authors: Emergency Medicine and Surgery, Macerata hospital, Macerata, Italy.
authors: Cristian
authors: C
authors: Tranà
authors: Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
authors: Waldemar
authors: W
authors: Uhl
authors: 1st Surgical Clinic, University Hospital of St. Ann Brno, Brno, Czech Republic.
authors: Libor
authors: L
authors: Urbánek
authors: Department of Surgery, Radboud University Medical Center, Nijmegen, Netherlands.
authors: Harry
authors: H
authors: van Goor
authors: Infection Prevention/Epidemiology, Providence Saint John's Health Center, Santa Monica, CA USA.
authors: Angela
authors: A
authors: Vassallo
authors: Infection Control Unit, Angers University, CHU d'Angers, Angers, France.
authors: Jean Ralph
authors: JR
authors: Zahar
authors: Department of Surgery, Ancona University Hospital, Ancona, Italy.
authors: Emanuele
authors: E
authors: Caproli
authors: Clinic of Infectious Diseases, St Orsola-Malpighi University Hospital, Bologna, Italy.
authors: Pierluigi
authors: P
authors: Viale