Antonio Ramos1, Jorge Ortiz2, Ángel Asensio3, Rocío Martínez-Ruiz4, Elena Múñez5, Mireia Cantero3, Alberto Cozar2, Piedad Ussetti6, José Portolés7, Valentín Cuervas-Mons8. 1. Unidad de Enfermedades Infecciosas, Departamento de Medicina Interna, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Majadahonda, Madrid, Spain Spanish Network for Research in Infectious Diseases (REIPI), Sevilla, Spain aramosm@salud.madrid.org. 2. Departamento de Medicina Interna, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 3. Departamento de Medicina Preventiva, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 4. Departamento de Microbiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 5. Unidad de Enfermedades Infecciosas, Departamento de Medicina Interna, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 6. Departamento de Neumología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 7. Departamento de Nefrología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 8. Unidad de Transplante Hepático, Departamento de Medicina Interna, Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid, Majadahonda, Madrid, Spain.
Abstract
BACKGROUND: There is limited knowledge about specific risk factors for Clostridium difficile infection (CDI). METHOD: A retrospective study comparing cases of CDI in solid organ transplant (SOT) recipients with controls (SOT recipients who did not present CDI). RESULTS: Thirty patients with SOT from 1340 transplantation recipients had at least 1 episode of CDI (2.23%). The accumulated incidence was 3.06% in liver transplantation, 2.78% in lung transplantation, 2.36% in kidney transplantation, and 0.33% in heart transplantation. Seven (23%) cases occurred during the first 2 months. Fifteen (50%) cases were community acquired. Colonoscopy was performed in 6 (20%) cases, but pseudomembranes were observed in only 1 (16%) case. Independent variables found to be related to CDI were previous treatment with proton pump inhibitors (PPIs; odds ratio [OR] 5.5; 95% confidence interval [CI] 1.2-32.0), immunosuppressive regimen including mycophenolate (OR 5.2; 95%CI 1.1-18), hospitalization during the previous 3 months (OR 5.1; 95%CI 1.1-17), and antibiotic treatment during the previous month (OR 6.7; 95%CI 1.4-23). Five (16.7%) patients did not respond to the initial treatment. Recurrences were noted in 6 (20%) patients. CONCLUSIONS: Liver transplant recipients presented the highest incidence. Risk factors for CDI were previous treatment with PPIs, immunosuppressive regimen containing mycophenolate, prior hospitalization, and prior antibiotic treatment.
BACKGROUND: There is limited knowledge about specific risk factors for Clostridium difficileinfection (CDI). METHOD: A retrospective study comparing cases of CDI in solid organ transplant (SOT) recipients with controls (SOT recipients who did not present CDI). RESULTS: Thirty patients with SOT from 1340 transplantation recipients had at least 1 episode of CDI (2.23%). The accumulated incidence was 3.06% in liver transplantation, 2.78% in lung transplantation, 2.36% in kidney transplantation, and 0.33% in heart transplantation. Seven (23%) cases occurred during the first 2 months. Fifteen (50%) cases were community acquired. Colonoscopy was performed in 6 (20%) cases, but pseudomembranes were observed in only 1 (16%) case. Independent variables found to be related to CDI were previous treatment with proton pump inhibitors (PPIs; odds ratio [OR] 5.5; 95% confidence interval [CI] 1.2-32.0), immunosuppressive regimen including mycophenolate (OR 5.2; 95%CI 1.1-18), hospitalization during the previous 3 months (OR 5.1; 95%CI 1.1-17), and antibiotic treatment during the previous month (OR 6.7; 95%CI 1.4-23). Five (16.7%) patients did not respond to the initial treatment. Recurrences were noted in 6 (20%) patients. CONCLUSIONS: Liver transplant recipients presented the highest incidence. Risk factors for CDI were previous treatment with PPIs, immunosuppressive regimen containing mycophenolate, prior hospitalization, and prior antibiotic treatment.
Authors: Lars F Westblade; Michael J Satlin; Shady Albakry; Brittany Botticelli; Amy Robertson; Tricia Alston; Matthew Magruder; Lisa T Zhang; Emmanuel Edusei; Kevin Chan; Michelle Lubetzky; Darshana M Dadhania; Eric G Pamer; Manikkam Suthanthiran; John R Lee Journal: Transpl Infect Dis Date: 2019-10-24 Impact factor: 2.228
Authors: M Schmidt-Hieber; J Bierwirth; D Buchheidt; O A Cornely; M Hentrich; G Maschmeyer; E Schalk; J J Vehreschild; Maria J G T Vehreschild Journal: Ann Hematol Date: 2017-11-24 Impact factor: 3.673