Toxigenic Clostridioides difficile colonization as a risk factor for development of C. difficile infection in solid-organ transplant patients. Infect Control Hosp Epidemiol 2021 Mar;42(3):287-291
Date
09/17/2020Pubmed ID
32933595DOI
10.1017/ice.2020.431Scopus ID
2-s2.0-85092160301 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
BACKGROUND: The association between Clostridioides difficile colonization and C. difficile infection (CDI) is unknown in solid-organ transplant (SOT) patients. We examined C. difficile colonization and healthcare-associated exposures as risk factors for development of CDI in SOT patients.
METHODS: The retrospective study cohort included all consecutive SOT patients with at least 1 screening test between May 2017 and April 2018. CDI was defined as the presence of diarrhea (without laxatives), a positive C. difficile clinical test, and the use of C. difficile-directed antimicrobial therapy as ordered by managing clinicians. In addition to demographic variables, exposures to antimicrobials, immunosuppressants, and gastric acid suppressants were evaluated from the time of first screening test to the time of CDI, death, or final discharge.
RESULTS: Of the 348 SOT patients included in our study, 33 (9.5%) were colonized with toxigenic C. difficile. In total, 11 patients (3.2%) developed CDI. Only C. difficile colonization (odds ratio [OR], 13.52; 95% CI, 3.46-52.83; P = .0002), age (OR, 1.09; CI, 1.02-1.17; P = .0135), and hospital days (OR, 1.05; 95% CI, 1.02-1.08; P = .0017) were independently associated with CDI.
CONCLUSIONS: Although CDI was more frequent in C. difficile colonized SOT patients, the overall incidence of CDI was low in this cohort.
Author List
Keegan J, Buchan BW, Ledeboer NA, Zhou Z, Hong JC, Graham MB, Munoz-Price LSAuthors
Blake W. Buchan PhD Professor in the Pathology department at Medical College of WisconsinMary Beth Graham MD Associate Chief, Professor in the Medicine department at Medical College of Wisconsin
John M. Keegan MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Nathan A. Ledeboer PhD Vice Chair, Professor in the Pathology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Clostridium InfectionsHumans
Organ Transplantation
Retrospective Studies
Risk Factors