Risk Factors for <i>Clostridium Difficile</i> Diarrhea in Patients With Solid Organ Transplantation

Ramos, Antonio; Ortíz, Jorge; Asensio, Ángel; Martínez-Ruiz, Rocío; Múñez, Elena; Cantero, Mireia; Cozar, Alberto; Ussetti, Piedad; Pórtoles, José; Cuervas-Mons, Valentín

doi:10.1177/1526924816655073

Cited by 15 publications

(12 citation statements)

References 44 publications

(92 reference statements)

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“…We observed that while CDI may occur during the immediate post‐transplant period, the majority of cases occur beyond 30 days, and many during 2‐24 months after transplantation. This observation is in line with a previous report . Many of the risk factors for CDI after SOT are observed during this period, including hospitalization, antibiotic use, augmented immunosuppressive therapies, and use of proton‐pump inhibitors …”

Section: Discussionsupporting

confidence: 92%

“…This study demonstrates the common occurrence of CDI in HT recipients, with one in every 10 patients developing this infection during the post‐transplant period. This is similar to the incidence rates of CDI in HT recipients as reported in the literature . We observed that while CDI may occur during the immediate post‐transplant period, the majority of cases occur beyond 30 days, and many during 2‐24 months after transplantation.…”

Section: Discussionsupporting

confidence: 90%

“…Hence, studies that focused on risk factors and outcome of CDI in HT and heart‐lung transplant (HLT) recipients are scarce. In the limited number of studies, the estimated incidence rate of CDI in HT and HLT recipients ranged from 8% to 14.9% . Length of hospitalization and severe hypogammaglobulinemia have been identified as risk factors of CDI in HT patients .…”

Section: Introductionmentioning

confidence: 99%

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

Bruminhent

Cawcutt

Petterson

et al. 2017

Clinical Transplantation

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Bruminhent

Cawcutt

Petterson

et al. 2017

Clinical Transplantation

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“…This is the situation with Clostridium difficile , a major cause of gut infection in individuals following antibiotic treatment 54, 55 and whose infection is associated with a reduction in gut microbiota diversity 56 . Given C. difficile ’s low susceptibility to antibiotics, the best way for fighting recurrent infections caused by this pathogen is restoring the functionality of the gut microbiota via fecal transplantation 57– 60 .…”

Section: Multi-hierarchical Antibiotic Selection Of Bacterial Populatmentioning

confidence: 99%

Effect of antibiotics on bacterial populations: a multi-hierarchical selection process

Martínez

2017

F1000Res

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Antibiotics have been widely used for a number of decades for human therapy and farming production. Since a high percentage of antibiotics are discharged from the human or animal body without degradation, this means that different habitats, from the human body to river water or soils, are polluted with antibiotics. In this situation, it is expected that the variable concentration of this type of microbial inhibitor present in different ecosystems may affect the structure and the productivity of the microbiota colonizing such habitats. This effect can occur at different levels, including changes in the overall structure of the population, selection of resistant organisms, or alterations in bacterial physiology. In this review, I discuss the available information on how the presence of antibiotics may alter the microbiota and the consequences of such alterations for human health and for the activity of microbiota from different habitats.

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“…In another study focused on solid organ transplant recipients, predominately kidney transplant recipients, 25% to 40% of etiologies were identified . Norovirus has been reported to account for approximately 25% of post‐transplant diarrhea cases and C difficile infection occurs in 2% to 7% of kidney transplant recipients …”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal pathogen colonization and the microbiome in asymptomatic kidney transplant recipients

Westblade

Satlin

Albakry

et al. 2019

Transplant Infectious Dis

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Background:In kidney transplant recipients, gastrointestinal (GI) pathogens in feces are only evaluated during diarrheal episodes. Little is known about the prevalence of GI pathogens in asymptomatic individuals in this population. Methods:We recruited 142 kidney transplant recipients who provided a non-diarrheal fecal sample within the first 10 days after transplantation. The specimens were evaluated for GI pathogens using the BioFire ® FilmArray ® GI Panel (BioFire Diagnostics, LLC), which tests for 22 pathogens. The fecal microbiome was also characterized using 16S rRNA gene sequencing of the V4-V5 hypervariable region. We evaluated whether detection of Clostridioides difficile and other GI pathogens was associated with post-transplant diarrhea within the first 3 months after transplantation.Results: Among the 142 subjects, a potential pathogen was detected in 43 (30%) using the GI Panel. The most common organisms detected were C difficile (n = 24, 17%), enteropathogenic Escherichia coli (n = 8, 6%), and norovirus (n = 5, 4%). Detection of a pathogen on the GI panel or detection of C difficile alone was not associated with future post-transplant diarrhea (P > .05). The estimated number of gut bacterial species was significantly lower in subjects colonized with C difficile than those not colonized with a GI pathogen (P = .01). Conclusion:Colonization with GI pathogens, particularly C difficile, is common at the time of kidney transplantation but does not predict subsequent diarrhea. Detection of C difficile carriage was associated with decreased microbial diversity and may be a biomarker of gut dysbiosis.

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Risk Factors for Clostridium Difficile Diarrhea in Patients With Solid Organ Transplantation

Abstract: Liver transplant recipients presented the highest incidence. Risk factors for CDI were previous treatment with PPIs, immunosuppressive regimen containing mycophenolate, prior hospitalization, and prior antibiotic treatment.

Cited by 15 publications

References 44 publications

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

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

Effect of antibiotics on bacterial populations: a multi-hierarchical selection process

Gastrointestinal pathogen colonization and the microbiome in asymptomatic kidney transplant recipients

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