Clostridioides difficile Infection in Patients after Organ Transplantation—A Narrative Overview

Abstract

Clostridioides difficile infection (CDI) is one of the most common causes of antibiotic-associated diarrhea. The pathogenesis of this infection participates in the unstable colonization of the intestines with the physiological microbiota. Solid-organ-transplant (SOT) patients and patients after hematopoietic stem cell transplantation are more prone to CDI compared to the general population. The main CDI risk factors in these patients are immunosuppressive therapy and frequent antibiotic use leading to dysbiosis. The current review article provides information about the risk factors, incidence and course of CDI in patients after liver, kidney, heart and lung transplantation and hematopoietic stem cell transplantation.

Clostridioides difficile Infection in Kidney Transplant Recipients

“…While immunosuppression regimens containing tacrolimus and MMF are implicated in increasing the risk of non-infectious diarrhea as well, it has been demonstrated by multiple studies that elevated tacrolimus levels, which are linked to decreased interleukin-2 production, may compromise immune responses, therefore heightening vulnerability to CDI [ 24 , 29 , 30 ]. Histopathological findings from intestinal mucosa biopsies of MMF-treated patients displayed inflammatory alterations—crypt cell apoptosis, atrophy, abscesses, and erosion—which can lead to colitis, chronic diarrhea, and cause gut dysbiosis [ 31 ].…”