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Fri Jan 4 17:10:24 GMT 2008

Ken,

We have taken out 2 colons in the last 12 months for the exact circumstances you are describing.  Patients were toxic, with temps >102, WBC >30K (31,500 and 38,000!!!) , on pressors and having profuse diarrhea.  The second went to the OR without the final culture results - a pretty ballsie move, if you ask me.  BUT - the cultures came back positive, the patient, who was close to death and on pressors, is alive and home, and he is very happy about that!  Would I have done the same - I am still not sure I have the nerve, but I will let you all know what I do if I end up in the same situation....

Ron

>>> <KMATTOX at aol.com> 1/3/2008 11:17 PM >>>
In Houston, particular in the suburbs, cases of SEVERE RESISTANT C.  
Difficile are being seen.    Resistant to both Flagyl and  Vancomycin.    WBCs as high 
as 80,000.   Often in  immunosuppressed patients, but not necessarily in HIV 
infected  patients.   Seems that the patients are on PPI  drugs.     I am 
aware of the CDC reports and a few of the  recent case reports.    From ONE 
hospital in Houston (not mine) I  am aware of 6 cases.      A couple have had 
operations  because even after 8 weeks they were still very sick and at operation 
they had  thickened large bowel.     

I am reporting this for two reasons:

1.    Have you seen such severe resistance in  C.difficile?
2.    If this is a NEW phenomena, then we need to  spread the word.

k

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RESISTANT Clostridium difficile