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P-073 Preoperative Risk Factors for Postoperative Clostridium Difficile Infection in Ileal Pouch Patients

BACKGROUND: The association between preoperative Clostridium difficile infection (CDI) and postoperative CDI in ileal pouch patients has not been investigated. The aim of the study was to evaluate whether preoperative CDI has an impact on the occurrence of postoperative CDI in patients with the ileal pouch. METHODS: Consecutive eligible ileal pouch patients from between February 2005 and December 2012 were identified from the Pouchitis Registry. Patients in the Registry with known the status of CDI of the pouch were surveyed with a structured questionnaire regarding the preoperative C. difficile test and its treatment. Medical records were also reviewed. Demographics and clinical characteristics and outcomes were evaluated with univariable and multivariable analyses. RESULTS: A total of 412 patients who were tested for CDI after pouch surgery were surveyed and 145 patients (35.2%) returned the questionnaires. A total of 102 patients with preoperative C. difficile test were identified for this study and 21 patients (20.6%) tested positive for C. difficile test after colectomy. On logistic regression analysis, male patients were 7.85 (95% confidence interval [CI]: 1.99, 30.94, P = 0.003) times more likely to have CDI than women. In addition, preoperative significant comorbidities (odds radio [OR] = 4.37; 95% CI: 1.09, 17.55; P = 0.037) and preoperative use antibiotics for other indications (OR = 5.72; 95% CI: 1.71,19.19; P = 0.005) were found to be associated with postoperative CDI of the pouch. However, there is no evidence to suggest that the preoperative CDI was associated with the occurrence of postoperative CDI (OR = 1.20; 95% CI: 0.36, 3.99, P = 0.769). CONCLUSIONS: Postoperative CDI occurred frequently in male patients with IPAA. In addition, preoperative comorbidities and antibiotic use were found to be risk factors. However, preoperative CDI did not appear to be associated with an increased risk for postoperative CDI in pouch patients.