Vondran M, et al. - In patients undergoing cardiac surgery, researchers identified risk factors for a fulminant Clostridium difficile (CD) infection (CDI). They reviewed a total of 41,466 patients who had cardiac surgery at their institution between April 1999 and April 2011, of those, a total of 1,256 patients (3.0%) who had post-operative diarrheal disease and tested positive for CD were included in this observational study. The factors that independently predicted a fulminant CDI after cardiac surgery were diabetes mellitus type 2, pre-operative ventilation, utilization of more than 8 units of red blood cell concentrates or of more than 5 fresh-frozen plasma units, and a cross-clamp time > 130 min. For the prevention of a fulminant CDI development by establishing early onset of therapy, close monitoring of high-risk patients were considered important.