Epidemiology and prevention of Clostridioides difficile infection in patients undergoing pancreatoduodenectomy (narrative review)

Aim. To summarize and analyze current data on the epidemiological characteristics and preventive measures of Clostridioides difficile infection in patients after pancreatoduodenectomy, with a focus on risk factors, infection incidence, and strategies to reduce postoperative morbidity. Materials and Methods. A comprehensive literature search was conducted using MEDLINE, Embase, Scopus, Cochrane, PubMed, and Google Scholar databases, as well as through citation tracking of studies published between June 2005 and June 2025. The review included systematic reviews and meta-analyses, single- and multicenter studies, cross-sectional, observational, prospective, cohort studies, and randomized controlled trials in both Russian and English. Results. Patients who underwent pancreatoduodenectomy were found to be at high risk of developing Clostridioides difficile infection due to a combination of factors. High prevalence of C. difficile was noted in surgical departments, with severe disease particularly associated with hypervirulent ribotypes (e.g., 027). Conclusion. C. difficile infection poses a serious threat to patients after pancreatoduodenectomy. Timely diagnosis, strict infection control, and rational use of antisecretory and antibacterial agents are key preventive measures. Further epidemiological and clinical studies are needed to better define risk factors and to develop effective management protocols for these patients.

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