Detection of Clostridium difficile in Stool Samples From Patients in the Early Period After Liver Transplantation

Kawecki, D.; Chmura, A.; Pacholczyk, Marek; Łągiewska, B; Adadyński, L; Wasiak, Dariusz; Małkowski, Piotr; Sawicka-Grzelak, A.; Rokosz, A; Szymanowska, Amelia; Swoboda-Kopeć, Ewa; Wróblewska, Marta; Rowińskí, W; Durlik, M.; Pączek, Leszek; Łuczak, M.

doi:10.1016/j.transproceed.2007.08.047

Cited by 7 publications

(6 citation statements)

References 22 publications

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“…CDC is not uncommon in transplant recipients, as they often possess 1 or more predisposing risk factors; however, existing literature suggests that transplantation does not impart additional risk for infection (1). Our data support this notion, as only 2.1% of lung transplant recipients developed CDC annually with a 7‐year cumulative incidence of 14.7% and a 7.4% (15/202) overall incidence, well within the reported incidence range of 1–17% (1, 6–8).…”

Section: Discussionsupporting

confidence: 83%

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Clostridium difficile colitis in lung transplantation

Gunderson

Gupta

Lopez

et al. 2008

Transplant Infectious Dis

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Section: Discussionsupporting

confidence: 83%

“…Fortunately, reported incidences of CDC in solid organ recipients appear no greater than those for hospitalized patients who have not undergone transplantation, varying from 1 to 17% (1, 6–8) with a high in 1 report of 31% (3). However, the incidence of CDC in lung transplantation is unclear and not well characterized.…”

mentioning

confidence: 99%

Clostridium difficile colitis in lung transplantation

Gunderson

Gupta

Lopez

et al. 2008

Transplant Infectious Dis

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“…Diarrhea, as a side effect of immunosuppressive therapy, is a frequent clinical symptom in SOT patients. The presumed disruption of the intestinal microflora because of immunosuppression, enteral nutrition, and antimicrobial therapy can facilitate CD growth and toxin production [12,13,15]. Although nearly all the antimicrobial classes have been associated with CDAD, clindamycin, cephalosporins, fluoroquinolones, and penicillins have been implicated as high‐risk agents.…”

Section: Discussionmentioning

confidence: 99%

“…Solid organ transplant (SOT) recipients are among the highest risk groups for this infection because of impaired defense mechanisms resulting from immunosuppressive therapy, and perioperative antibiotic use [9,10]. The estimated reported incidence of CDAD in SOT recipients ranges from 3 to 7% in liver recipients to 2.1-31% in lung transplantation [7,[11][12][13][14][15][16][17][18]. The aim of this study was to characterize the epidemiology and risk factors for the development and to assess the outcome of CDAD in a large cohort of patients undergoing SOT.…”

Section: Introductionmentioning

confidence: 99%

Outcome ofClostridium difficile-associated disease in solid organ transplant recipients: a prospective and multicentre cohort study

Len

Rodríguez-Pardo

Gavaldá

et al. 2012

Transplant International

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Clostridium difficile‐associated disease (CDAD) is the most common cause of nosocomial diarrhea. Information about CDAD in solid organ transplant (SOT) recipients is scarce. To determine its epidemiology and risk factors, we conducted a cohort study in which 4472 SOT patients were prospectively included in the RESITRA/REIPI (Spanish Research Network for the Study of Infection in Transplantation) database between July 2003 and July 2006. Forty‐two episodes of CDAD were diagnosed in 36 patients. The overall incidence was 0.94%. Median onset of infection was 31.5 days (range 6–741); in half the cases, onset occurred during the first month after transplantation. In 26% of cases, there was no previous antibiotic use. Independent risk factors for CDAD using Cox regression analysis were previous use of first‐ and second‐generation cephalosporins (HR 3.68; 95%CI 1.8–7.52; P < 0.001), ganciclovir prophylactic use (HR 3.09; 95%CI 1.44–6.62; P = 0.004) and corticosteroid use before transplantation (HR 2.95; 95%CI 1.1–7.9; P = 0.031). There were no deaths related to CDAD. In summary, the incidence of CDAD in SOT was low, most cases were diagnosed soon after transplantation and the prognosis was good.

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“…Broad‐spectrum antibiotics are often used in immunosuppressed individuals, including patients who have received lung transplants. This frequent antibiotic use depletes the normal flora of the gastrointestinal tract (7, 8, 12–14).…”

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confidence: 99%

Clostridium difficile colitis in children following lung transplantation

Rosen

Schecter²,

Heinle³

et al. 2010

Pediatric Transplantation

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Risk factors for Clostridium difficile diarrhea are antibiotic exposure, hospitalization, extreme ages, and immunodeficiency. Patients with CF have a high rate of colonization with C. difficile. We performed a retrospective chart review of patients at Texas Children's Hospital who underwent lung transplantation since the inception of our program in October 2002 until October 2008. There were 78 pediatric lung transplants performed at our institution during the study period. Four patients developed six total episodes of CDC for an overall incidence of 5.4%. CF was the underlying diagnosis in all four patients, leading to an incidence of 8.9% in patients with CF. Two patients developed colitis within the first four months following transplant, and the other two patients developed colitis more than three yr after transplantation. All four patients required hospitalization, and three patients were managed medically while one patient underwent diverting ileostomy. One experienced renal insufficiency and subsequently expired. Overall survival was 75% among patients with CDC following lung transplantation. CDC causes significant morbidity and mortality in children with CF who have undergone lung transplantation.

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Detection of Clostridium difficile in Stool Samples From Patients in the Early Period After Liver Transplantation

Cited by 7 publications

References 22 publications

Clostridium difficile colitis in lung transplantation

Clostridium difficile colitis in lung transplantation

Outcome ofClostridium difficile-associated disease in solid organ transplant recipients: a prospective and multicentre cohort study

Clostridium difficile colitis in children following lung transplantation

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