Toxigenic Clostridioides difficile colonization as a risk factor for development of C. difficile infection in solid-organ transplant patients

Jack Keegan, Blake W. Buchan, Nathan A. Ledeboer, Zhipeng Zhou, Johnny C. Hong, Mary Beth Graham, L. Silvia Munoz-Price

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: The association between Clostridioides difficile colonization and C. difficile infection (CDI) is unknown in solid-organ transplant (SOT) patients. We examined C. difficile colonization and healthcare-Associated exposures as risk factors for development of CDI in SOT patients. Methods: The retrospective study cohort included all consecutive SOT patients with at least 1 screening test between May 2017 and April 2018. CDI was defined as the presence of diarrhea (without laxatives), a positive C. difficile clinical test, and the use of C. difficile-directed antimicrobial therapy as ordered by managing clinicians. In addition to demographic variables, exposures to antimicrobials, immunosuppressants, and gastric acid suppressants were evaluated from the time of first screening test to the time of CDI, death, or final discharge. Results: Of the 348 SOT patients included in our study, 33 (9.5%) were colonized with toxigenic C. difficile. In total, 11 patients (3.2%) developed CDI. Only C. difficile colonization (odds ratio [OR], 13.52; 95% CI, 3.46-52.83; P =.0002), age (OR, 1.09; CI, 1.02-1.17; P =.0135), and hospital days (OR, 1.05; 95% CI, 1.02-1.08; P =.0017) were independently associated with CDI. Conclusions: Although CDI was more frequent in C. difficile colonized SOT patients, the overall incidence of CDI was low in this cohort.

Original languageEnglish (US)
Pages (from-to)287-291
Number of pages5
JournalInfection Control and Hospital Epidemiology
Volume42
Issue number3
DOIs
StatePublished - Mar 2021

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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