A multicenter, retrospective, case-cohort study of the epidemiology and risk factors for Clostridium difficile infection among cord blood transplant recipients

2017 ◽  
Vol 19 (4) ◽  
pp. e12728 ◽  
Author(s):  
Carolyn D. Alonso ◽  
David A. Braun ◽  
Ishan Patel ◽  
Mona Akbari ◽  
Daniel Jungmyung Oh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Clostridium Difficile ◽  
Cord Blood ◽  
Clostridium Difficile Infection ◽  
Transplant Recipients ◽  
Retrospective Case ◽  
Cord Blood Transplant

Epidemiology, risk factors, and outcome of Clostridium difficile infection in heart and heart-lung transplant recipients

2017 ◽  
Vol 31 (6) ◽  
pp. e12968 ◽  
Author(s):  
Jackrapong Bruminhent ◽  
Kelly A. Cawcutt ◽  
Charat Thongprayoon ◽  
Tanya M. Petterson ◽  
Walter K. Kremers ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Heart Lung Transplant ◽  
Lung Transplant Recipients

An insight into Clostridium difficile infection: a single-center retrospective case-control study

2019 ◽  
Vol 57 (10) ◽  
pp. 1183-1195
Author(s):  
Fady G. Haddad ◽  
Julie Zaidan ◽  
Abhishek Polavarapu ◽  
Hafiz Khan ◽  
Asif Khan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Patient Characteristics ◽  
Healthcare Facility ◽  
Control Group ◽  
Retrospective Case ◽  
Neutrophil Lymphocyte Ratio ◽  
Factors Associated ◽  
Icu Transfer

Abstract Background Clostridium difficile infection (CDI) has become a worldwide health problem in view of its significant incidence and medical and economic impact on the health system. Prior studies have been undergone about risk factors and disease characteristics. We wanted to study the characteristics, prognostic factors associated with CDI at our institute, as well as a new prognostic factor. Methods Our study aimed at describing the risk factors, patient characteristics, and outcomes associated with healthcare facility–acquired CDI (HCFA-CDI) and community-acquired CDI (CA-CDI). We intended to identify the factors associated with worse outcomes. We evaluated the characteristics associated with CDI over 3 years. We also evaluated a simple neutrophil-lymphocyte ratio (NLR) and its predictive value for worse outcomes. Results Six hundred patients were enrolled (333 in a control group; 171 in the HCFA-CDI group and 96 in the CA-CDI group). NLR > 5 predicted increased mortality and intensive care unit transfer in all CDI if done as early as day 2 after CDI diagnosis. In HCFA-CDI, NLR > 5 predicted a higher ICU transfer if done as early as day 1 post-diagnosis and with increased mortality as early as day 2 post-diagnosis. In CA-CDI, NLR > 5 predicted a higher mortality and ICU transfer if done at least 4 days after diagnosis. Moreover, every 10-unit increase in NLR was associated with a significant increase in mortality and ICU transfer in patients with CDI. Conclusion A timely use of NLR can be used as a mean to predict worse outcomes, namely ICU transfer and mortality, in patients with CDI.

scholarly journals 2673. Risk Factors for Clostridium difficile Infection in Lung Transplant Patients

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S938-S938
Author(s):  
Joseph L DeRose ◽  
Peter Axelrod ◽  
Rafik Samuel ◽  
Heather Clauss
Keyword(s):  
United States ◽  
Risk Factors ◽  
Clostridium Difficile ◽  
Lung Transplantation ◽  
Clostridium Difficile Infection ◽  
Lung Transplant ◽  
The United States ◽  
Transplant Recipients ◽  
Transplant Patients ◽  
Lung Transplants

Abstract Background Clostridium difficile infection is a serious and common illness affecting almost 500,000 people in the United States each year. Solid-organ transplant recipients are at increased risk for this infection, with lung transplant patients being at the highest risk. Temple University Hospital (TUH) in Philadelphia has performed the most lung transplants in the United States over the last 2 years. Methods A retrospective case–control study was performed to identify patients diagnosed with C. difficile following lung transplantation at our institution between January 1, 2014 and April 30, 2018 (N = 35). We randomly selected control patients (N = 35) who had lung transplantation performed during this time but did not develop C. difficile infection. The study objectives were to characterize risk factors that are associated with C. difficile infection in lung transplant recipients and compare clinical outcomes in recipients with and without C. difficile. Statistical analysis was performed using Epi Info (CDC, Atlanta GA). Results The average age was 62.4 years, 64.7% were male, 75% were white and 69.1% of transplants were performed for underlying idiopathic pulmonary fibrosis. 52.9% of patients had “non-severe” C. difficile infection as defined by the 2018 Infectious Disease Society of America guidelines. Patients with C. difficile infection were more likely to have been treated for cytomegalovirus (CMV) viremia (OR 8.2, 95% CI 2.4–28.2, P = 0.0006) and were more likely to have received third- to fifth-generation cephalosporins (OR 4.0, 95% CI 1.4–11.2, P = 0.01) and/or carbapenems (OR 3.7, 95% CI 1.4–9.9, P = 0.02). Patients with C. difficile infection were more likely to experience multiple hospitalizations when compared with C. difficile-negative patients (3.6 vs. 8.4, P = 0.003). 22 of the 68 evaluable patients died during the study period, 9 of whom had C. difficile infection (P = NS). Conclusion Patients who received lung transplants and developed C. difficile infection were more likely to be treated for CMV viremia, receive antibiotics including cephalosporins and/or carbapenems and require repeat hospitalizations when compared with control patients who did not develop C. difficile infection following transplant. Disclosures All authors: No reported disclosures.

Risk factors associated with Clostridium difficile infection in kidney transplant recipients

2018 ◽  
Vol 20 (4) ◽  
pp. e12918 ◽  
Author(s):  
M.L. Spinner ◽  
B.R. Stephany ◽  
P.M. Cerrato ◽  
S.W. Lam ◽  
E.A. Neuner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Kidney Transplant ◽  
Clostridium Difficile Infection ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Factors Associated

scholarly journals Incidence and risk factors of a severe Clostridium difficile infection: results of a retrospective cohort study at a tertiary care hospital

2019 ◽  
Author(s):  
Claas Baier ◽  
Simone Valentin ◽  
Frank Schwab ◽  
Sandra Steffens ◽  
Ralf-Peter Vonberg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Care Hospital ◽  
Care Clinic ◽  
Independent Risk Factors

Abstract Background Clostridium difficile infection (CDI) is a relevant healthcare burden worldwide and one of the leading causes for nosocomial diarrhea. Besides mild courses, the development of a severe infection can occur and has a relevant impact on healthcare costs and patient outcome.Methods We conducted a retrospective cohort study over a 4 year-long period to analyze the incidence of CDI and the contributing risk factors for a severe course at a tertiary care clinic. Independent risk factors were determined by a multivariable logistic regression analysis.Results A total of 761 CDI cases were identified in the study period, thereof 612 (80.4%) cases were nosocomially acquired. The mean incidence for a CDI was 0.42 cases per 1000 patient-days. A severe CDI occurred in 131 cases (17.2%). Independent risk factors for a severe course were pulmonary disease, a Charlson comorbidity index >3, and a preceding antibiotic therapy within three months with glycopeptides (vancomycin/teicoplanin) and/or aminoglycosides.Conclusions This study highlights the relevant burden of CDI in hospitals. Moreover, it underscores that specific knowledge of risk factors contributing to severe CDI is crucial to optimize treatment, infection prevention measures and to guide clinical monitoring and therapy strategy.

scholarly journals 528Evaluating Risk Factors for Clostridium difficile Infection in Adult and Pediatric Hematopoietic Cell Transplant Recipients

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S17-S17
Author(s):  
Nicole Boyle ◽  
Sara Podczervinski ◽  
Alex Morrison ◽  
Susan Butler-Wu ◽  
Danielle Zerr ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Transplant Recipients ◽  
Hematopoietic Cell Transplant
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