Prevalence of Clostridium difficile in defunctioned colons: P055

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Aim:This exploratory study aims to collect initial information on theprevalence of Clostridium difficile bacteria in defunctioned colons. This will help us to determine whether these patients are at increased risk of Clostridium difficile colitis following restoration of bowel continuity.Method:Patients admitted for reversal of defunctioning ileostomy wereprospectively recruited. Two stool samples were collected form the ileostomy bagprior to the operation and another two from the first two bowel motions after the operation. All samples were cultured for Clostridium difficile colonisation and analysed for toxin A&B by Premier EIA test. Demographic data and data of possible confounding factors were also collected.Results:Seventeen adult patients were recruited to this study. Two patients had positive stool culture for Clostridium difficile in the post-operative samples and another patient developed clinical pseudomembranous colitis with positive toxin. This indicates a possible colonisation rate of 6-44% (95% confidence interval) i.e. higher than the 3% rate for the normal population.Conclusion:Clostridium difficile colonisation is significant in patients having restoration of bowel continuity in this study. This may be related to colonic flora disturbance, mucosal ischemia or nutritional factors that are thought to be associated with diversion colitis affecting defunctioned colon.

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