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Clostridioides difficile infection in patients with hematological malignancy: A multicenter study in Taiwan.
- Source :
-
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi [J Microbiol Immunol Infect] 2021 Dec; Vol. 54 (6), pp. 1101-1110. Date of Electronic Publication: 2021 Feb 20. - Publication Year :
- 2021
-
Abstract
- Background: Among the individuals with hematological malignancy (HM) complicated with Clostridioides difficile infection (CDI), the variables associated with in-hospital mortality and recurrence of CDI were investigated.<br />Material and Methods: Including adults with HM and those without malignancy suffering from CDI from January 2015 to December 2016 in three hospitals in Taiwan.<br />Results: Totally 314 patients including 77 with HM and 237 patients without malignancy were included. HM patients more often had low leukocyte counts (<500 cells/mL: 28.6% vs. 2.1%) than those without malignancy and more patients without malignancy had severe CDI than patients with HM (31.6% vs. 14.3%, P = .003), according to the severity score of IDSA/SHEA. Patients with HM had a higher recurrence rate of CDI (14.3%, 11/77 vs. 7.2%, 17/237; P = .07) and longer hospital stay (47.2 ± 40.8 days vs. 33.3 ± 37.3 days; P = .006) than those without malignancy. In the multivariate analyses for those with HM and CDI, the in-hospital mortality was associated with vancomycin-resistant Enterococcus (VRE) colonization or infection (odds ratio [OR] 7.72; P = .01), and C. difficile ribotype 078 complex infection (OR 9.22; P = .03). Moreover underlying hematological malignancy (OR 2.74; P = .04) and VRE colonization/infection (OR 2.71; P = .02) were independently associated with CDI recurrence.<br />Conclusion: Patients with HM complicated with CDI were often regarded as non-severe infection, but had a similar in-hospital mortality rate as those without malignancy. CDI due to ribotype 078 complex isolates heralded a poor prognosis among HM patients.<br />Competing Interests: Declaration of competing interest All authors report no conflicts of interest relevant to this article.<br /> (Copyright © 2021. Published by Elsevier B.V.)
- Subjects :
- Adult
Aged
Clostridium Infections diagnosis
Clostridium Infections microbiology
Clostridium Infections mortality
Female
Hematologic Neoplasms diagnosis
Hematologic Neoplasms microbiology
Hematologic Neoplasms mortality
Hospital Mortality
Hospitalization
Humans
Leukocyte Count
Male
Middle Aged
Odds Ratio
Prognosis
Recurrence
Risk Factors
Severity of Illness Index
Taiwan epidemiology
Clostridioides difficile classification
Clostridioides difficile genetics
Clostridium Infections complications
Hematologic Neoplasms complications
Subjects
Details
- Language :
- English
- ISSN :
- 1995-9133
- Volume :
- 54
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi
- Publication Type :
- Academic Journal
- Accession number :
- 33678554
- Full Text :
- https://doi.org/10.1016/j.jmii.2021.02.002