BACKGROUND: Clostridium difficile infection (CDI) and associated mortality in solid organ transplant recipients is rising, but data are scarce in lung transplant recipients. We aimed to characterize CDI and its effect on mortality in a large cohort of lung transplant recipients. METHODS: Lung transplant recipients were identified from our transplant database from 2000 to 2011. Cox proportional hazard models were used to calculate hazard ratios for CDI and death after adjusting for potential confounders identified from bivariate analysis. RESULTS: We identified 388 patients (196 female, 192 male), with a median age of 56 years (range, 8-75 years), during the study period. CDI developed after transplant in 89 (22.9%), with 27 (7.0%) developing CDI during the initial hospitalization at a mean diagnosis of 12.7 ± 11.4 days. Incidence varied widely each year (median, 24%; range, 5%-32%), with the highest rates in 2007 to 2008. Post-operative length of stay was identified as a significant predictor of CDI (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.01-1.03). Early CDI was an independent significant predictor of death (HR, 1.96; 95% CI, 1.14-3.36) as well as CDI anytime after transplant (HR, 1.61; 95% CI, 1.02-2.52). CONCLUSIONS: CDI rates varied widely from 2000 through 2011, with the highest rates in 2007 to 2008. Lung transplant recipients who developed CDI had a higher risk of death, especially when CDI occurred in the first 6 months after transplant.
BACKGROUND:Clostridium difficileinfection (CDI) and associated mortality in solid organ transplant recipients is rising, but data are scarce in lung transplant recipients. We aimed to characterize CDI and its effect on mortality in a large cohort of lung transplant recipients. METHODS: Lung transplant recipients were identified from our transplant database from 2000 to 2011. Cox proportional hazard models were used to calculate hazard ratios for CDI and death after adjusting for potential confounders identified from bivariate analysis. RESULTS: We identified 388 patients (196 female, 192 male), with a median age of 56 years (range, 8-75 years), during the study period. CDI developed after transplant in 89 (22.9%), with 27 (7.0%) developing CDI during the initial hospitalization at a mean diagnosis of 12.7 ± 11.4 days. Incidence varied widely each year (median, 24%; range, 5%-32%), with the highest rates in 2007 to 2008. Post-operative length of stay was identified as a significant predictor of CDI (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.01-1.03). Early CDI was an independent significant predictor of death (HR, 1.96; 95% CI, 1.14-3.36) as well as CDI anytime after transplant (HR, 1.61; 95% CI, 1.02-2.52). CONCLUSIONS: CDI rates varied widely from 2000 through 2011, with the highest rates in 2007 to 2008. Lung transplant recipients who developed CDI had a higher risk of death, especially when CDI occurred in the first 6 months after transplant.
Authors: E R Dubberke; K A Reske; M A Olsen; K Bommarito; A A Cleveland; F P Silveira; M G Schuster; C A Kauffman; R K Avery; P G Pappas; T M Chiller Journal: Transpl Infect Dis Date: 2018-03-06 Impact factor: 2.228
Authors: Julia Origüen; Mario Fernández-Ruiz; Carlos Lumbreras; María Ángeles Orellana; Francisco López-Medrano; Tamara Ruiz-Merlo; Rafael San Juan; Ana García-Reyne; Esther González; Natalia Polanco; Estela Paz-Artal; Amado Andrés; José María Aguado Journal: Infection Date: 2015-02-13 Impact factor: 3.553
Authors: Jennifer L Hsu; James J Enser; Trevor McKown; Glen E Leverson; John D Pirsch; Timothy M Hess; Nasia Safdar Journal: Clin Transplant Date: 2014-01-30 Impact factor: 2.863
Authors: Suresh Paudel; Ioannis M Zacharioudakis; Fainareti N Zervou; Panayiotis D Ziakas; Eleftherios Mylonakis Journal: PLoS One Date: 2015-04-17 Impact factor: 3.240
Authors: Seyed M Hosseini-Moghaddam; Bin Luo; Sarah E Bota; Shahid Husain; Michael S Silverman; Nick Daneman; Kevin A Brown; J Michael Paterson Journal: JAMA Netw Open Date: 2021-12-01