Clostridium difficile infection is associated with graft loss in solid organ transplant recipients. Issue 7 (25th January 2018)

• Record Type: Journal Article
• Authors: Cusini, A.; Béguelin, C.; Stampf, S.; Boggian, K.; Garzoni, C.; Koller, M.; Manuel, O.; Meylan, P.; Mueller, N. J.; Hirsch, H. H.; Weisser, M.; Berger, C.; van Delden, C.
• Other Names: Achermann Rita investigator.; Amico Patrizia investigator.; Aubert John‐David investigator.; Banz Vanessa investigator.; Beldi Guido investigator.; Benden Christian investigator.; Binet Isabelle investigator.; Bochud Pierre‐Yves investigator.; Bucher Heiner investigator.; Bühler Leo investigator.; Carell Thierry investigator.; Catana Emmanuelle investigator.; Chalandon Yves investigator.; de Geest Sabina investigator.; de Rougemont Olivier investigator.; Dickenmann Michael investigator.; Duchosal Michel investigator.; Elkrief Laure investigator.; Fehr Thomas investigator.; Ferrari‐Lacraz Sylvie investigator.; Gasche Soccal Paola investigator.; Gaudet Christophe investigator.; Giostra Emiliano investigator.; Golshayan Déla investigator.; Hadaya Karine investigator.; Halter Jörg investigator.; Heim Dominik investigator.; Hess Christoph investigator.; Hillinger Sven investigator.; Hofbauer Günther investigator.; Huynh‐Do Uyen investigator.; Immer Franz investigator.; Klaghofer Richard investigator.; Laesser Bettina investigator.; Lehmann Roger investigator.; Lovis Christian investigator.; Marti Hans‐Peter investigator.; Martin Pierre Yves investigator.; Mohacsi Paul investigator.; Morel Philippe investigator.; Mueller Ulrike investigator.; Mueller‐McKenna Helen investigator.; Müller Antonia investigator.; Müller Thomas investigator.; Müllhaupt Beat investigator.; Nadal David investigator.; Pascual Manuel investigator.; Passweg Jakob investigator.; Rick Juliane investigator.; Roosnek Eddy investigator.; Rosselet Anne investigator.; Rothlin Silvia investigator.; Ruschitzka Frank investigator.; Schanz Urs investigator.; Schaub Stefan investigator.; Schnyder Aurelia investigator.; Seiler Christian investigator.; Steiger Jürg investigator.; Stirnimann Guido investigator.; Toso Christian investigator.; Venetz Jean‐Pierre investigator.; Villard Jean investigator.; Wick Madeleine investigator.; Wilhelm Markus investigator.; Yerly Patrick investigator.;
• Is Part Of: American journal of transplantation. Volume 18:Issue 7(2018)
• Page Start: 1745
• Page End: 1754
• Publication Date: 2018-01-25
• Subjects: antibiotic: antibacterial -- clinical research/practice -- complication: infectious -- infection and infectious agents – bacterial: Clostridium difficile -- infectious disease; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.14640
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea in solid organ transplant recipients (SOT). We aimed to assess incidence, risk factors, and outcome of CDI within the Swiss Transplant Cohort Study (STCS). We performed a case‐control study of SOT recipients in the STCS diagnosed with CDI between May 2008 and August 2013. We matched 2 control subjects per case by age at transplantation, sex, and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors and evaluate outcome of CDI. Two thousand one hundred fifty‐eight SOT recipients, comprising 87 cases of CDI and 174 matched controls were included. The overall CDI rate per 10 000 patient days was 0.47 (95% confidence interval ([CI] 0.38‐0.58), with the highest rate in lung (1.48, 95% CI 0.93‐2.24). In multivariable analysis, proven infections (hazard ratio [HR] 2.82, 95% CI 1.29‐6.19) and antibiotic treatments (HR 4.51, 95% CI 2.03‐10.0) during the preceding 3 months were independently associated with the development of CDI. Despite mild clinical presentations, recipients acquiring CDI posttransplantation had an increased risk of graft loss (HR 2.24, 95% CI 1.15‐4.37; P = .02). These findings may help to improve the management of SOT recipients. Abstract : The authors demonstrate that despite mild clinical presentations and good clinical responses, Clostridium difficile infections are associated with an increased risk of graft loss in the Swiss Transplant Cohort Study.