TY - JOUR
T1 - Toxigenic Clostridioides difficile colonization as a risk factor for development of C. difficile infection in solid-organ transplant patients
AU - Keegan, Jack
AU - Buchan, Blake W.
AU - Ledeboer, Nathan A.
AU - Zhou, Zhipeng
AU - Hong, Johnny C.
AU - Graham, Mary Beth
AU - Munoz-Price, L. Silvia
N1 - Publisher Copyright:
©
PY - 2021/3
Y1 - 2021/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85092160301&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85092160301&partnerID=8YFLogxK
U2 - 10.1017/ice.2020.431
DO - 10.1017/ice.2020.431
M3 - Article
C2 - 32933595
AN - SCOPUS:85092160301
SN - 0899-823X
VL - 42
SP - 287
EP - 291
JO - Infection Control and Hospital Epidemiology
JF - Infection Control and Hospital Epidemiology
IS - 3
ER -