<i>Clostridium difficile</i>
 infection in intestinal transplant recipients

Goldenberg, Vanessa; Berbel, Ana; Camargo, José F.; Simkins, Jacques

doi:10.1111/tri.13074

Cited by 9 publications

(7 citation statements)

References 6 publications

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“…5,[16][17][18] The incidence of CDI among pediatric SOT in this study was similar to adult studies summarized in a meta-analysis that reported an overall rate of 7.4%. 3 Rates in the current study did differ based on type of organ, which is consistent with other studies, reporting the highest rates of 20% in small bowel transplant recipients, 19 followed by 18% for liver, 12 5%-16% for kidney, 12,20 9% for heart, 12 5%-9% for lung, 21 and 3%-7% for pancreas. There is limited evidence regarding the best treatment of CDI in pediatric populations.…”

Section: Discussionsupporting

confidence: 91%

A multicenter study to define the epidemiology and outcomes of Clostridioides difficile infection in pediatric hematopoietic cell and solid organ transplant recipients

Mayer

Maron

Dallas

et al. 2020

American Journal of Transplantation

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Hematopoietic cell transplant (HCT) and solid organ transplant (SOT) recipients are at increased risk for Clostridioides difficile infection (CDI). We conducted a multicenter retrospective study to describe the incidence of CDI in children transplanted between January 2010 and June 2013. Nested case-control substudies, matched 1:1 by transplant type, institution, patient age, and time of year (quartile) of transplant, identified CDI risk factors. Cohorts included 1496 HCT and 1090 SOT recipients.

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Section: Discussionsupporting

confidence: 91%

A multicenter study to define the epidemiology and outcomes of Clostridioides difficile infection in pediatric hematopoietic cell and solid organ transplant recipients

Mayer

Maron

Dallas

et al. 2020

American Journal of Transplantation

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“…These patients had predominantly community-acquired CDI and only 40% required hospital admission, with the median time to CDI being 204 days. 25 The trends of CDI in the intestinal transplant recipients remained high during the study period (2010-2017), which replicates the results from the Canadian SOT cohort that showed the incidence of CDI increased from 23 cases per 1000 person year in 2004 to 68 cases per 1000 person year in 2011 and remained high from 2011 to 2017. 16 The variation in the 2015 may be due to the duplicate coding of CDI after ICD-9 to ICD-10 transition.…”

Section: Discussionsupporting

confidence: 79%

“…Another study showed that the incidence of CDI 1 year post–intestinal transplant was 20%; this study included both adults and pediatric patients, and the baseline characters of the CDI and non‐CDI groups were similar. These patients had predominantly community‐acquired CDI and only 40% required hospital admission, with the median time to CDI being 204 days 25 . The trends of CDI in the intestinal transplant recipients remained high during the study period (2010–2017), which replicates the results from the Canadian SOT cohort that showed the incidence of CDI increased from 23 cases per 1000 person year in 2004 to 68 cases per 1000 person year in 2011 and remained high from 2011 to 2017 16 .…”

Section: Discussionmentioning

confidence: 99%

An analysis of the outcomes of Clostridioides difficile occurring in intestinal transplant recipients requiring hospitalization

Amjad

Schiano

Segovia

et al. 2023

Transplant Infectious Dis

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Background: Organ transplantation is a known risk factor for Clostridioides difficile infection (CDI). There is limited published data on the impact of CDI in the intestinal transplant population. Methods:We utilized the National Readmission Database (2010Database ( -2017 to study the outcomes of CDI in patients having a history of intestinal transplantation. Association of CDI with readmission and hospital resource utilization was computed in multivariable models adjusted for demographics and comorbidities. Results: During 2010-2017, 8442 hospitalizations with the history of intestinal transplantation had indexed hospital admissions. Of these, 320 (3.8%) had CDI. CDI hospitalization in intestine transplant patients was associated with higher median cost $54 430 (IQR: 27 231, 109 980) as compared to patients who did not have CDI $48 888 (IQR: 22 578, 112 777), (β: 71 814 95% confidence intervals [CI]: 676-142 953, p = .048). The median length of stay was also longer for patients with CDI 7 (IQR: 4, 13) days as compared to 5 (IQR: 3, 11) days in non-CDI (β: 5.51 95% CI: 0.73-10.29, p = .02). The mortality rate, intestinal transplant complications, presence of malnutrition, acute kidney injury, ICU admissions, and sepsis were similar in both groups. CDI was the top cause of 30-day readmission in the intestinal transplant recipients with CDI during the index admission; the number of 30-day readmissions also increased from 2010 to 2017. Conclusion: CDI hospitalization in post-intestine transplant patients occurs commonly and is associated with a longer length of stay and higher costs during hospitalization. The CDI was the most common cause of readmission after the index admission of CDI in these patients.

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“…This high rate is thought to be related to frequent hospitalizations, and antibiotic and proton pump inhibitor use in these patients. 28 Histological findings of ACR may occur concurrently with CDI; in one recent pediatric case series, three of four patients who developed CDI had evidence of mild ACR on biopsy.…”

Section: Infectionsmentioning

confidence: 99%

The role of endoscopy in the small intestinal transplant recipient: A review

Crismale

Mahmoud

Moon

et al. 2021

American Journal of Transplantation

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Intestinal transplantation (ITx) is the treatment of choice for patients with intestinal failure (IF) who have developed complications related to total parenteral nutrition (TPN), including recurrent line sepsis, intestinal failure-associated liver disease, and complications related to vascular access. 1 Approximately 40% of patients on the ITx waiting list require ITx as part of combined liver-intestine transplantation or multivisceral transplantation (MVTx), with indications including primary end-stage liver disease complicated by porto-mesenteric thrombosis or secondary liver failure related to long-term TPN use. 2

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Clostridium difficile infection in intestinal transplant recipients

Cited by 9 publications

References 6 publications

A multicenter study to define the epidemiology and outcomes of Clostridioides difficile infection in pediatric hematopoietic cell and solid organ transplant recipients

A multicenter study to define the epidemiology and outcomes of Clostridioides difficile infection in pediatric hematopoietic cell and solid organ transplant recipients

An analysis of the outcomes of Clostridioides difficile occurring in intestinal transplant recipients requiring hospitalization

The role of endoscopy in the small intestinal transplant recipient: A review

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