Risk factors and impact of Clostridium difficile recurrence on haematology patients

Scappaticci, Gianni B.; Perissinotti, Anthony J.; Nagel, Jerod; Bixby, Dale; Marini, Bernard L.

doi:10.1093/jac/dkx005

Cited by 29 publications

(24 citation statements)

References 35 publications

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“…Patients under antibiotic treatment were at a higher risk for acquiring C. difficile (RR: 3.81, OR: 5.29, p <0.05). These results are in agreement with those of Gianni et al ( 27 ) who reported that previous antibiotic use is the predominant risk factor for C. difficile acquisition, with relative risk of 5.9. Females were at a significantly higher risk for acquiring C. difficile than males (RR: 1.5, OR: 1.22, p < 0.05) which agreed with what was reported by Timothy et al ( 28 ) (OR: 1.50, p: < 0.05).…”

Section: Discussionsupporting

confidence: 93%

Clinical and microbial characterization of toxigenic Clostridium difficile isolated from antibiotic associated diarrhea in Egypt

Elgendy¹,

Aly²,

Fathy³

et al. 2020

IJM

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Background and Objectives: Clostridium difficile infection (CDI) has become a significant healthcare-associated infection throughout the world and is particularly important in developing countries. This study aimed to investigate clinical characterization and risk factors related to toxigenic C. difficile infection in adult and pediatric patients, antimicrobial susceptibility pattern. Also, to evaluate different diagnostic methods for rapid detection of C. difficile associated diarrhea (CDAD) in Egypt. Materials and Methods: Stool samples were collected from 95 pediatric patients and 37 adult patients suffering from antibiotic associated diarrhea and were subjected to direct toxin immunoassay and culture on cycloserine/cefoxitin/fructose agar. The presence of tcdA and tcdB genes was tested by PCR. Results: Toxigenic C. difficile was isolated from pediatric and adult patients at a rate of 17.89% (17/95) and 27% (10/37) respectively. The sensitivity and specificity of direct PCR from stool are (100%, 100% and 82.4%, 100%) in adult and pediatric samples respectively. The susceptibility of C. difficile to vancomycin and metronidazole were found to be 66.7% and 48.2% respectively. Conclusion: Diabetes mellitus, prior antibiotic treatment, hematological malignancy on chemotherapy, malnutrition, neutropenia and Ryle feeding are risk factors for development of CDAD. Tight restriction of unnecessary antibiotic uses is necessary in our locality. Direct detection of toxin genes in stool by PCR is sensitive and specific method for early detection of C. difficile.

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Section: Discussionsupporting

confidence: 93%

Clinical and microbial characterization of toxigenic Clostridium difficile isolated from antibiotic associated diarrhea in Egypt

Elgendy¹,

Aly²,

Fathy³

et al. 2020

IJM

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“…Indeed, a large Spanish study suggests a higher increase of CDI in hospitalized female patients compared to men of the same age (Esteban-Vasallo et al, 2016). However, in the allo-HSCT cohort, the distribution of sex was similar in both CDI and NCDI groups; in agreement, several studies of hematological patients suggested no sex differences (Alonso et al, 2013;Bilgrami et al, 1999;Scappaticci et al, 2017;Trifilio et al, 2013). Therefore, the statistical female overrepresentation might as well be an epiphenomenon in our study.…”

Section: Discussionsupporting

confidence: 85%

Impact of Clostridioides difficile infection on the outcome of patients receiving a hematopoietic stem cell transplantation

Weber

Scheich

Magh

et al. 2020

International Journal of Infectious Diseases

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Objectives: Clostridioides difficile infections (CDI) are common in autologous (auto-HSCT) or allogenic hematopoietic stem cell transplant (allo-HSCT) recipients. However, the impact of CDI on patient outcomes is controversial. We conducted this study to examine the impact of CDI on patient outcomes. Methods: We performed a retrospective single-center study, including 191 lymphoma patients receiving an auto-HSCT and 276 acute myeloid leukemia (AML) patients receiving an allo-HSCT. The primary endpoint was overall survival (OS). Secondary endpoints were causes of death and, for the allo-HSCT cohort, GvHD-and relapse-free survival (GRFS). Results: The prevalence of CDI was 17.6% in the AML allo-HSCT and 7.3% in the lymphoma auto-HSCT cohort. A higher prevalence of bloodstream infections, but no differences concerning OS or cause of death were found for patients with CDI in the auto-HSCT cohort. [AU] In the allo-HSCT cohort, OS and GRFS were similar between CDI and non-CDI patients. However, the leading cause of death was relapse among non-CDI patients, but it was infectious diseases in the CDI group with fewer deaths due to relapse. Conclusions: CDI was not associated with worse survival in patients receiving a hematopoietic stem cell transplantation, and there were even fewer relapse-related deaths in the AML allo-HSCT cohort.

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“…Apesar dos esforços para prevenir a CDI nos últimos anos, sua incidência vem aumentando no mundo (Raza et al, 2010), com uma variabilidade nas diferentes regiões, ressaltando a importância das investigações regionais. No leste da China, Fang et al, (2014) encontraram uma prevalência de 20,5% de CDI em três hospitais oncológicos; na Espanha esse percentual foi de 17,3% (Garzotto et al, 2015) e nos EUA, a incidência de CDI foi de aproximadamente 7-14% em adultos com câncer (Scappaticci et al, 2017).…”

Section: Discussionunclassified

Baixa prevalência de infecções por Clostridioides difficile em Hospitais de Referência em Oncologia

Tenório

Araújo

Lins³

et al. 2021

RSD

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As infecções por Clostridioides difficile (CDI) aumentaram em gravidade e incidência durante a última década. O câncer predispõe os pacientes à CDI, devido à maior exposição aos fatores de risco. O presente estudo teve como objetivo determinar a prevalência, resposta clínica, desfecho, descrever os fatores de risco estabelecidos na literatura em pacientes oncológicos com CDI. O estudo foi realizado em dois serviços de referência em oncologia de Recife/PE e envolveu pessoas com idade ≥18 anos, que apresentaram o quadro de diarreia após 48horas da admissão hospitalar, no período de novembro/2017 a agosto/2019. Para o diagnóstico de CDI foi utilizado o exame Reação em Cadeia da Polimerase em Tempo Real (qRT-PCR). Um total de 156 pacientes foram incluídos, a CDI foi identificada em 7,05% (11/156) dos pacientes estudados, todos isolados foram rastreados e amplificados por qRT-PCR quanto à presença dos genes que codificam as toxinas A e B (tcdA e tcdB), toxina binária (cdtA) e triose fosfato isomerase (tpi). O câncer de mama 27,3% (3/11) e a leucemia linfóide aguda 18,2% (2/11) foram os cânceres mais frequentes; 90,9% (10/11) fizeram uso de antibióticos e 63,6% (7/11) dos casos evoluíram para óbito. Apesar de utilizar a técnica qRT-PCR, que é a mais sensível e específica, a prevalência de CDI foi baixa 7,05% (11/156), não houve registros de casos de CDI graves, sendo a maioria dos casos leves, o que sugere uma circulação de cepas com baixa virulência que determinam menor morbidade e mortalidade.

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Risk factors and impact of Clostridium difficile recurrence on haematology patients

Abstract: Haematology patients exhibit a higher rate of rCDI than general hospitalized patients. Utilization of this multivariable model to guide index CDI therapy at index may help to decrease the rCDI and prevent delays or interruptions in chemotherapy.

Cited by 29 publications

References 35 publications

Clinical and microbial characterization of toxigenic Clostridium difficile isolated from antibiotic associated diarrhea in Egypt

Clinical and microbial characterization of toxigenic Clostridium difficile isolated from antibiotic associated diarrhea in Egypt

Impact of Clostridioides difficile infection on the outcome of patients receiving a hematopoietic stem cell transplantation

Baixa prevalência de infecções por Clostridioides difficile em Hospitais de Referência em Oncologia

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