Back to Search
Start Over
Early Clostridioides difficile infection characterizations, risks, and outcomes in allogeneic hematopoietic stem cell and solid organ transplant recipients
- Source :
- Transplant infectious disease : an official journal of the Transplantation SocietyREFERENCES. 24(1)
- Publication Year :
- 2021
-
Abstract
- Background Clostridioides difficile infection (CDI) frequently complicates allogeneic hematopoietic stem cell (allo-HCT) and solid organ transplantation (SOT). Methods We retrospectively analyzed risk factors and outcomes of CDI occurring within 30 days of transplant. Results Between March 2010 and June 2015, 466 allo-HCT and 1454 SOT were performed. The CDI cumulative incidence (95% CI) was 10% (8-13) and 4% (3-5), following allo-HCT and SOT, respectively (p < .01), occurring at a median (range) 7.5 days (1-30) and 11 (1-30), respectively (p = .18). In multivariate analysis, fluoroquinolones use within 14 days pre-transplantation was a risk factor for CDI following allo-HCT (HR 4.06 [95% CI 1.31-12.63], p = .02), and thoracic organ(s) transplantation was a risk factor for CDI following SOT (HR 3.03 [95% CI 1.31-6.98]) for lung and 3.90 (1.58-9.63) for heart and heart/kidney transplant, p = .02. Compared with no-CDI patients, the length of stay (LOS) was prolonged in both allo-HCT (35 days [19-141] vs. 29 [13-164], p < .01) and SOT with CDI (16.5 [4-101] vs. 7 [0-159], p < .01), though not directly attributed to CDI. In allo-HCT, severe acute graft-versus-host disease (aGVHD) occurred more frequently in patients with CDI (33.3% vs. 15.8% without CDI, p = .01) and most aGVHD (87.5%) followed CDI. Non-relapse mortality or overall survival, not attributed to CDI, were also similar in both allo-HCT and SOT. Conclusions Early post-transplant CDI is frequent, associated with fluoroquinolones use in allo-HCT and the transplanted organ in SOT, and is associated with longer LOS in both the groups without difference in survival but with increased aGVHD in allo-HCT.
- Subjects :
- Diarrhea
medicine.medical_specialty
genetic structures
Epidemiology
Hypogammaglobulinemia
rates
outcomes
Gastroenterology
allogeneic hematopoietic stem cell transplant
hemic and lymphatic diseases
Internal medicine
risk factors
Toxins
Medicine
Humans
Disease
Cumulative incidence
In patient
Risk factor
Antibody
Retrospective Studies
Transplantation
Lung
business.industry
Clostridioides difficile
solid organ transplant
Hematopoietic Stem Cell Transplantation
Hematopoietic stem cell
Organ Transplantation
Colitis
Hematopoietic Stem Cells
mortality
Transplant Recipients
surgical procedures, operative
Infectious Diseases
medicine.anatomical_structure
Clostridioides difficile infection
Clostridium Infections
business
Solid organ transplantation
Clostridioides
Subjects
Details
- ISSN :
- 13993062
- Volume :
- 24
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Transplant infectious disease : an official journal of the Transplantation SocietyREFERENCES
- Accession number :
- edsair.doi.dedup.....df5c254ba509b978b5d790d9176f3ce8