Outcomes of Patients Who Develop Symptomatic Clostridium difficile Infection After Solid Organ Transplantation

Mitu-Pretorian, O.-M.; Forgács, B.; Qumruddin, A.; Tavakoli, A.; Augustine, Titus; Pararajasingam, Ravi

doi:10.1016/j.transproceed.2010.04.057

Cited by 23 publications

(14 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The frequency of CDI reported among solid organ transplant patients ranges from 3 to 16%, with the highest incidence in the early transplant hospitalization period and the tendency to increase in the last years . The rate of CDI in our center was found relatively low reaching 5.4%, which consorts with current literature on the subject where the rate in a large series was lower than ours, at 3.5% . Moreover, current literature supports the overall incidence of CDI among hospitalized patients varying from 1% to 50% and a large series of general surgical patients in the USA reported an incidence of 0.52% CDI after a general surgical admission .…”

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 80%

“…Infection with CD (CDI) leads to toxin‐mediated invasive colitis with characteristic clinical and pathological presentation. The incidence of CDI among patients who have had solid organ transplants is reported to range from 3% to 16% . Predisposing factors include long hospital stay, immunosuppression, medications, abdominal surgery, chemotherapy, and older age .…”

mentioning

confidence: 99%

See 2 more Smart Citations

Clostridium difficile infection among kidney transplant recipients: frequency, clinical presentation, and outcome

Lionaki

Panagiotellis

Moris

et al. 2014

APMIS

View full text Add to dashboard Cite

The objective of this study was to evaluate the frequency of Clostridium Difficile Infection (CDI) among kidney transplant recipients and describe the clinical picture in correlation with the presence of certain risk factors. We included kidney transplant recipients with a functioning graft, who were admitted during the period 1/2012-12/2013, and patients with ESRD who were admitted to undergo Kidney Transplantation (KTx) from a deceased or a living donor in the same period. Patients were screened following clinical indication of gastrointestinal infection. CDI diagnosis was based on a positive stool sample for CD toxins and stool culture. Within the period 2012-2013, we recorded 24 cases of CDI in 19 patients, accounting for a frequency of 5.4% of CDI in our population. In addition to diarrhea, 63.15% of the patients presented with fever, 31.25% with anorexia, while abdominal pain was a rare symptom (0.53%). None of the patients had ileus, bowel obstruction or megacolon. Fourteen patients (73.7%) had a history of recent exposure (15 days) to antimicrobial agents prior to the evolution of CDI symptoms. A relapse of the CDI infection was identified in five cases. CDI infection is a significant factor of morbidity in patients with KTx and should be considered in the clinical setting of diarrhea, even in cases with no exposure to antibiotic agents.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 80%

mentioning

confidence: 99%

See 1 more Smart Citation

Clostridium difficile infection among kidney transplant recipients: frequency, clinical presentation, and outcome

Lionaki

Panagiotellis

Moris

et al. 2014

APMIS

View full text Add to dashboard Cite

show abstract

“…In one study of kidney recipients, the attributable mortality of CDI was 0.7%, higher than the observed loss of transplant grafts due to thrombosis and rejection. 99 In a study of lung transplant recipients, 54% of CDI occurred within the first 6 months of transplant; and these early CDI patients had a higher risk of death. 100 In this cohort, 70% of CDI occurred after discharge from the initial hospitalization, such as in the outpatient setting or during readmissions for complications, rather than immediately post-operatively.…”

Section: Epidemiology Of CDImentioning

confidence: 99%

Clostridium difficile

Curry¹

2010

Clinics in Laboratory Medicine

View full text Add to dashboard Cite

SYNOPSIS Clostridium difficile infections (CDI) have emerged as one of the principal threats to the health of hospitalized and immunocompromised patients. Nucleic acid testing for C. difficile toxin genes has eclipsed traditional clinical diagnostics for CDI in sensitivity and is now widespread in clinical use, but preliminary evidence suggests that this may have come at a cost of substantially reduced positive predictive value. The importance of C. difficile colonization is increasingly recognized not only as a source for false positive clinical testing but also as a source of new infections within hospitals and other healthcare environments. In the last five years, several new treatment strategies that capitalize on the increasing understanding of the altered microbiome and host defenses in CDI patients have completed clinical trials, including fecal microbiota transplantation (FMT). This article highlights the changing epidemiology, laboratory diagnostics, pathogenesis, and treatment of CDI.

show abstract

“…The spectrum of infectious causes is quite large and varies over time after transplantation. For example, Clostridium difficile is implicated as a causal agent in the first month after transplantation , perhaps because of the use of antibiotics in the first day after the surgical procedure . Bacterial infections, viral infections, and opportunistic infections occur later, usually 6 months after transplantation .…”

mentioning

confidence: 99%

Acute enteritis associated with Coxsackievirus A19 in a kidney transplant patient

Melica

Langlois

Goff

et al. 2014

Transplant Infectious Dis

View full text Add to dashboard Cite

Diarrhea is a frequent complication after kidney transplantation, with an incidence rate between 22% and 51%. In many cases, the cause remains unknown. We describe here the first case, to our knowledge, of persistent diarrhea associated with Coxsackievirus A19 (CVA19) in a kidney transplant recipient. The patient was a 46-year-old man who received a deceased-donor kidney. He experienced delayed graft function because of donor kidney donation after circulatory determination of death. Maintenance immunosuppression consisted of low-dose cyclosporine, high-dose mycophenolate mofetil (MMF) (3 g/day), and prednisone (10 mg/day). He had severe diarrhea for 2 weeks associated with acute renal failure. No pathogens were found in the stool cultures. Enterovirus detection was positive by real-time polymerase chain reaction, and sequence analysis found CVA19 (from Enterovirus C group). Area under the curve of MMF was 48 mg.h/L. Because of the persistence of diarrhea, MMF was stopped and replaced by azathioprine. The diarrhea disappeared, but serum creatinine did not return to baseline. CVA19 rarely causes gastroenteritis. This case illustrates that MMF is not always the direct cause of diarrhea, and that new clinical infectious diseases will be detected with the expansion of molecular-based DNA diagnostics.

show abstract

Outcomes of Patients Who Develop Symptomatic Clostridium difficile Infection After Solid Organ Transplantation

Cited by 23 publications

References 10 publications

Clostridium difficile infection among kidney transplant recipients: frequency, clinical presentation, and outcome

Clostridium difficile infection among kidney transplant recipients: frequency, clinical presentation, and outcome

Clostridium difficile

Acute enteritis associated with Coxsackievirus A19 in a kidney transplant patient

Contact Info

Product

Resources

About