Outcome of Clostridium difficile-associated disease in solid organ transplant recipients: a prospective and multicentre cohort study

Clostridium difficile-associated disease (CDAD) is the most common cause of nosocomial diarrhea. Information about CDAD in solid organ transplant (SOT) recipients is scarce. To determine its epidemiology and risk factors, we conducted a cohort study in which 4472 SOT patients were prospectively incl...

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Detalles Bibliográficos
Autores: Len, O, Rodriguez-Pardo, D, Gavalda, J, Aguado, JM, Blanes, M, Borrell, N, Bou, G, Carratala, J, Cisneros, JM, Fortun, J, Gurgui, M, Montejo, M, Cervera, C, Munoz, P, Asensio, A, Torre-Cisneros, J, Pahissa, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2012
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p11026
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11026
Access Level:acceso abierto
Palabra clave:Clostridium difficile
diarrhea
epidemiology
transplantation
Descripción
Sumario:Clostridium difficile-associated disease (CDAD) is the most common cause of nosocomial diarrhea. Information about CDAD in solid organ transplant (SOT) recipients is scarce. To determine its epidemiology and risk factors, we conducted a cohort study in which 4472 SOT patients were prospectively included in the RESITRA/REIPI (Spanish Research Network for the Study of Infection in Transplantation) database between July 2003 and July 2006. Forty-two episodes of CDAD were diagnosed in 36 patients. The overall incidence was 0.94%. Median onset of infection was 31.5 days (range 6741); in half the cases, onset occurred during the first month after transplantation. In 26% of cases, there was no previous antibiotic use. Independent risk factors for CDAD using Cox regression analysis were previous use of first- and second-generation cephalosporins (HR 3.68; 95%CI 1.87.52; P < 0.001), ganciclovir prophylactic use (HR 3.09; 95%CI 1.446.62; P = 0.004) and corticosteroid use before transplantation (HR 2.95; 95%CI 1.17.9; P = 0.031). There were no deaths related to CDAD. In summary, the incidence of CDAD in SOT was low, most cases were diagnosed soon after transplantation and the prognosis was good.

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