Epidemiology, risk factors, and outcome of <i>Clostridium difficile</i> infection in heart and heart‐lung transplant recipients

Bruminhent, Jackrapong; Cawcutt, Kelly; Petterson, Tanya M.; Kremers, Walter K.; Razonable, Raymund R.

doi:10.1111/ctr.12968

Cited by 15 publications

(10 citation statements)

References 17 publications

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“…As was observed in other reports 1–4,6,8,9,12,17,21,32,50–52 , mortality increased substantially with CDI. This observation held after adjusting for age, sex, diabetes, CHF, baseline creatinine, and time-varying non- C. difficile infection (HR = 5.45, 95% CI: 2.14–13.87, p < 0.001).…”

Section: Discussionsupporting

confidence: 88%

A multi-institutional cohort study confirming the risks of Clostridium difficile infection associated with prolonged antibiotic prophylaxis

Kirkwood

Gulack

Iribarne

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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In this large multicenter prospective study of major infections following cardiac surgery, CDI was encountered in nearly 1% of patients, was frequently diagnosed postdischarge, and was associated with extended length of stay and substantially increased mortality. Patients with comorbidities, longer surgery time, extended antibiotic exposure, and/or hyperglycemic episodes were at increased risk for CDI.

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Section: Discussionsupporting

confidence: 88%

A multi-institutional cohort study confirming the risks of Clostridium difficile infection associated with prolonged antibiotic prophylaxis

Kirkwood

Gulack

Iribarne

et al. 2018

The Journal of Thoracic and Cardiovascular Surgery

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“…Most cases in this study were caused by early CMV infection, but a few cases were also noted in early citations [2][3][4][16][17][18]32,33]. Clostridium difficile diarrhea was not as frequent as previously reported [34], which could be explained by the restrictive antibiotic protocol and routine early enteral feed-ing approach.…”

Section: Discussionmentioning

confidence: 72%

In-Hospital Post-Operative Infection after Heart Transplantation: Epidemiology, Clinical Management, and Outcome

Gómez-López

Barge‐Caballero

Fernández-Ugidos

et al. 2020

Surgical Infections

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Background: Infection is a major cause of morbidity and mortality after heart transplantation (HT). Little information about its importance in the immediate post-operative period is available.The aim of this study was to analyze the characteristics, incidence, and outcomes of in-hospital post-operative infections after HT. Methods: We conducted an observational, single-center study based on 677 adults who underwent HT from 1991 to 2015 and who survived the surgical intervention. In-hospital post-operative infections were identified retrospectively according to the medical finding in the clinical records.Results: Over a mean hospital stay of 24.5 days, 239 patients (35.3%) developed 348 episodes of infection (2 episodes per 100 patient-days). The most common sources of infection were those related to invasive procedures (respiratory infections, 115 [33%]; urinary tract infections, 47 [13.5%]; bacteremia, 42 [12.1%]; surgical site infections, 25 [7.2%]), in addition to abdominal focus (33, 9.5%). Enterobacteriaceae (76, 21.8%) and gram-positive cocci (58, 16.7%) were the predominant germs, although opportunistic infections were not infrequent (69, 19.8%). Ninetyfive septic episodes were detected with a mean Sequential Organ Failure Assessment Score of 9.5 -5.3 points, with hemodynamic failure being the most severe organ dysfunction and renal dysfunction the most frequent one. Management included broad-spectrum antibiotics in 48.8% of episodes and surgical management in 13.8%. The overall antimicrobial success rate was 96.3%.Higher in-hospital mortality was observed among infected patients (15.1% vs. 10.3%), but this difference was not statistically significant (p = 0.067). The one-year survival and events were not different between patients suffering from a post-operative infection and those who did not. Conclusions:In-hospital infections were frequent in the post-operative period after HT and were associated with a poor short-term outcome. Patients who survived sepsis had a similar one-year morbidity and mortality compared with patients who did not develop an infection.

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“…Patients who have undergone solid organ transplant (SOT) are at risk of Clostridioides difficile infection (CDI), which is associated with significant morbidity and mortality. [1][2][3] A wide range of the cumulative CDI incidence has been reported in single-center studies 4,5 ; however, SOT-related CDI incidence has been rarely estimated at the population level. 6 Most studies have investigated early-onset CDI occurring within 90 days following transplant.…”

Section: Introductionmentioning

confidence: 99%

“…6 Most studies have investigated early-onset CDI occurring within 90 days following transplant. [4][5][6][7] However, the outcome of late-onset CDI has been rarely investigated. 4,5 Although early-onset infectious complications may affect allograft function, late-onset infectious diseases may be associated with allograft loss and death.…”

Section: Introductionmentioning

confidence: 99%

“… 4 , 5 , 6 , 7 However, the outcome of late-onset CDI has been rarely investigated. 4 , 5 Although early-onset infectious complications may affect allograft function, late-onset infectious diseases may be associated with allograft loss and death. 8 , 9 To our knowledge, post-CDI mortality has not been compared between patients who underwent SOT developing early- vs late-onset CDI.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Outcomes Associated With Clostridioides difficile Infection in Solid Organ Transplant Recipients

Hosseini-Moghaddam

Luo²,

Bota³

et al. 2021

JAMA Netw Open

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IMPORTANCELittle is known about the incidence and outcomes of Clostridioides difficile infection (CDI) in solid organ transplant (SOT) recipients. OBJECTIVE To estimate the CDI incidence and outcomes in SOT recipients. DESIGN, SETTING, AND PARTICIPANTSA population-based cohort study was conducted using administrative health care data for all Ontario, Canada, residents who received organ allografts from

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Epidemiology, risk factors, and outcome of Clostridium difficile infection in heart and heart‐lung transplant recipients

Abstract: Clostridium difficile infection after HT is more common among patients with combined heart-lung and those undergoing retransplantation. CDI was associated with a higher risk of mortality in HT recipients.

Cited by 15 publications

References 17 publications

A multi-institutional cohort study confirming the risks of Clostridium difficile infection associated with prolonged antibiotic prophylaxis

A multi-institutional cohort study confirming the risks of Clostridium difficile infection associated with prolonged antibiotic prophylaxis

In-Hospital Post-Operative Infection after Heart Transplantation: Epidemiology, Clinical Management, and Outcome

Incidence and Outcomes Associated With Clostridioides difficile Infection in Solid Organ Transplant Recipients

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