Risk of Clostridium Difficile Infection in Leukemia and Lymphoma Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5990-5990
Author(s):  
Mohamed Abdelfatah ◽  
Amr Mohamed ◽  
Nayfe Rabih ◽  
Enriquez Kathleen ◽  
Nijim Ala ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Conflicts Of Interest ◽  
Hematologic Malignancies ◽  
Control Group ◽  
Retrospective Case ◽  
Co Morbidity ◽  
Diarrheal Episode ◽  
Morbidity Index ◽  
Group 1

Abstract Background: Clostridium difficile is the most important cause of nosocomial infectious diarrhea. The prevelance of C. difficile infection (CDI) has been poorly investigated in patients with hematologic malignancies such as leukemia and lymphoma. Purpose: To evaluate the clostridium difficile infection (CDI) incidence, severity, recurrence, developing sepsis and 30-days mortality among hospitalized patients with Leukemia and lymphoma. Methods: IRB approved retrospective case control study. 2020 patients were admitted for >48 hours in our institution between July 2007 and December 2013 with CDI, and had adequate follow up. CDI was defined as more than 3 episodes of loose stools in less than 24 hrs with a positive CD stool toxin assay. Recurrent CDI (RCDI) defined as readmission for recurrent diarrhea with 2nd positive stool test 15 days following complete resolution of previous diarrheal episode and cessation of CDI treatment. Computerized medical records to investigate demographics, laboratory blood work, Carlson Co-morbidity index, and medication used. Patients were divided into leukemia lymphoma group and control group. Group-1 included all patients with Leukemia lymphoma; AML, CML, ALL CML. Univariate predictors of CDI and multiple logistic regressions were used to assess whether patients with leukemia lymphoma had higher incidence of severity, recurrence and mortality. Controlling for Age, Serum Albumin, modified Carlson Co-morbidity index (CCI), PPI, antibiotics, and CDI treatment. Results: 2020 patients had been identified; in group-1 19 out of 95 patients (25%) had RCDI. In the control group, 364 out of 1655 patients (18%) had RCDI (p=0.614). 30-days mortality 7 out of 95 patients died within group-1 versus 157 out of 1924 in control group (p=0.799). Criteria for sepsis was fulfilled in 37 out of 95 in group-1 versus 482 out of 1924 in control group (p=0.003) Conclusion: We conclude that hospitalized patient with Leukemia and lymphoma had higher incidence of developing sepsis from CDI. There was no difference in the incidence of recurrence and 30-days mortality between patients with Leukemia lymphoma than control group. Physicians should have high suspicious for CDI in Leukemia lymphoma patients. Depend on this study we suggest early diagnosis and starting second line stronger treatment may help in decrease the incidence of CDI related sepsis. Disclosures No relevant conflicts of interest to declare.

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 Clinical Features and Outcomes of Patients with Elizabethkingia Meningoseptica Infection: An Emerging Pathogen

2020 ◽  
Author(s):  
Abdullah Umair ◽  
Nosheen Nasir
Keyword(s):  
Hospital Stay ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Opportunistic Pathogen ◽  
University Hospital ◽  
Retrospective Case ◽  
First Case ◽  
Elizabethkingia Meningoseptica ◽  
Co Morbidity ◽  
Morbidity Index

Abstract Background:Elizabethkingia meningoseptica, formerly known as Chryseobacterium meningosepticum, is a non-motile, non-fastidious, catalase and oxidase-positive, aerobic, glucose-non-fermentative Gram-negative bacillus first defined by Elizabeth O. King in 1959. It has recently emerged as an opportunistic pathogen infecting people in the the extremes of age and the immunocompromised, especially in nosocomial settings. There has been an increased interest in this pathogen due to its rising occurrence around the world, its ubiquity in nature, and inherent capacity for antimicrobial resistance.Methods: We describe a retrospective case series at the Aga Khan University Hospital in Karachi, Pakistan on patients admitted from January 2013 to December 2018 with Elizabethkingia meningoseptica infections. All patients identified to have any clinical culture specimen positive for Elizabethkingia meningoseptica were included. Data was collected on a structured proforma from the Hospital Information Management Systems (HIMS).Results:Sixteen patients with E. meningoseptica were identified. The mean Charlson’s co-morbidity index was 3.25. Nine patients had bacteremia with E. meningosepticum. Three of the isolates were extensively drug resistant with sensitivity only to minocycline. Nine out of 16 patients required intubation and mechanical ventilation. The median length of hospital stay was 13 days and four out of 16 patients died during hospital stay,Conclusion: This is the first case series from Pakistan reporting Elizabethkingia meningoseptica infections.

scholarly journals Irritable bowel syndrome after Clostridium difficile infection

2019 ◽  
Author(s):  
Teodora Iacob ◽  
Mihaela Sorina Lupșe ◽  
Dan Lucian Dumitrașcu
Keyword(s):  
Irritable Bowel Syndrome ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Severe Form ◽  
Control Group ◽  
Tertiary Center ◽  
Rome Iii ◽  
Stool Form ◽  
Irritable Bowel ◽  
Gastroenteritis Episode

Abstract Background and Aim Post-Infectious Irritable Bowel Syndrome (PI-IBS) is a common complication of Clostridium difficile infection (CDI). The objectives of this study were to asses the risk of PI-IBS following a CDI. We also evaluated if there is a correlation between the onset of PI-IBS and the severity of CDI. Methods The study group consisted of 69 patients consecutively admitted in a tertiary center with an acute gastroenteritis episode, suspected of having a Clostridium difficile infection. PCR for CDI from feces were performed to assess the infection. The subjects were divided into two groups. A group consisted of patients with CDI and the other group where the CDI was ruled out. The patients were evaluated for PI-IBS 6 months after the episode of CDI by Rome III IBS diagnostic questionnaire and the Bristol Stool Form Scale. Severity of CDI was stratified according to the need for hospitalization or not. The questionnaires were paper printed and directly filled in by the subjects. Results The response rate to the questionnaire was 100%. During the course of this study 31 patients died. Out of 38 patients, 37% (14 patients) were diagnosed with CDI. After CDI, 57% (8 patients) developed PI-IBS and 43% (6 patients) where without PI-IBS with a relative risk (RR) of 2.29 (95 % confidence interval CI 0.99 – 5.23), p=0.04. In the group of patients with a severe form of CDI, 90% (9 patients) developed PI-IBS with a RR of 2.72 (95% CI 0.80 – 9.24), p=0.04, compared to the group of patients with light and moderate forms CDI. Conclusion Our study shows that, 6 months after CDI, PI-IBS develops in 57% patients, higher than in the control group where CDI was ruled out by PCR (43%), statitstically significant (p=0.04). The severity of CDI was a risk factor for PI-IBS, 90% of patients with severe forms of CDI developed PI-IBS.

scholarly journals An effect of single high dose of vitamin D3 on the risk of nosocomial infections, hospitalization time and mortality in hospitalized elderly population. A preliminary report

2020 ◽  
Vol 2 (2) ◽  
pp. 1-5
Author(s):  
Dorota Leszczyńska ◽  
Agata Tuszyńska ◽  
Magdalena Zgliczyńska ◽  
Wojciech Zgliczyński ◽  
Waldemar Misiorowski
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Vitamin D3 ◽  
Nosocomial Infections ◽  
Control Group ◽  
High Dose ◽  
Single High Dose ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
The Impact

Introduction: Observational studies indicate a significant impact of serum 25(OH)D concentration on incidence of hospital-acquired infections. However, we did not find any interventional study assessing the effect of vitamin D3 administration at the admission on the course of further hospitalization in internal medicine departments. Objective of the paper: Investigation of the impact of one-time high-dose vitamin D3 administration in elderly patients on the day of urgent admission to the hospital, on hospital-acquired infections. Materials and methods: A randomized, two-arms, open pilot study in 97 adults aged 60-100. A study group was given a single dose of 60,000 IU vitamin D3 and a control group was not subject to any intervention. Serum 25(OH)D and calcium were measured at the baseline and after 7 days. Results: 77.32% of studied patients were vitamin deficient, and among those, in 28.87% severe vitamin D deficiency was found. After single administration of 60,000 IU of vitamin D3, only 4 patients achieved recommended serum 25(OH)D concentration. The highest increase in serum 25(OH)D was observed in patients with severe deficiency. Numbers of observed nosocomial infections such as flu, hospital-acquired pneumonia or Klebsiella pneumoniae MBL+ infection did not differ significantly between study and control group, however there was a trend close to significance for lower incidence of Clostridium difficile infection in the vitamin D3 group. Conclusions: Preliminary results of the presented research indicate possible protective effect of single high dose of vitamin D3 against Clostridium difficile infection during hospitalization. Further research on larger group of patients, using higher dose of vitamin D3 is necessary.

scholarly journals Hospital acquired Clostridium difficile infection in pediatric wards: a retrospective case–control study

SpringerPlus ◽  
2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Ayse Karaaslan ◽  
Ahmet Soysal ◽  
Nurhayat Yakut ◽  
Gulsen Akkoç ◽  
Sevliya Ocal Demir ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Hospital Acquired ◽  
Control Study

Clostridium difficile Infection in Hospitalized Cirrhotic Patients with Hepatic Encephalopathy

2015 ◽  
Vol 24 (4) ◽  
pp. 423-428 ◽  
Author(s):  
Oana Cristina Stoica ◽  
Carol Stanciu ◽  
Camelia Cojocariu ◽  
Egidia Miftode ◽  
Lucian Boiculese ◽  
...  
Keyword(s):  
At Risk ◽  
Hepatic Encephalopathy ◽  
Clostridium Difficile ◽  
Enzyme Immunoassay ◽  
Clostridium Difficile Infection ◽  
Hepatorenal Syndrome ◽  
Control Group ◽  
Tertiary Referral Center ◽  
Cirrhotic Patients ◽  
Stool Samples

Background & Aims: Patients with liver cirrhosis are at-risk population for Clostridium difficile infection (CDI). There is a paucity of data on the incidence of CDI in cirrhotics with hepatic encephalopathy (HE). The aim of the study was to evaluate the incidence and risk factors for CDI in cirrhotics hospitalized with HE. Methods: A retrospective analysis of all cirrhotics with HE admitted at a tertiary referral center from January 2012 to December 2014 was made. Patients’ medical charts were reviewed, and demographics, laboratory parameters, antibiotics use, etiology of cirrhosis, and therapy of HE, as well as the results of stool samples for toxins A and B (enzyme immunoassay) were carefully searched. The presence of toxin A or B (or both) in stool samples was defined as CDI. Data on cirrhotics with HE and CDI (study group) were compared with those from patients without CDI (control group). Results: A total of 231 cirrhotic patients were hospitalized with HE mostly stage 2 and 3, and 17 (7.3%) of them were diagnosed with CDI. The overall CDI incidence rate was 57.2 cases per 10,000 patient-days. As compared with control patients, those with HE and CDI were more likely to have older age, increased serum creatinine level, hepatorenal syndrome (HRS), and more prior hospitalizations. On multivariate analysis, antibiotic therapy, age over 65 years, and HRS remained significantly related with the development of CDI. Conclusion: Hospitalized cirrhotics with HE are at risk for developing CDI, and clinicians treating such patients should be aware of this infection as rapid detection and prompt treatment may improve outcomes.Abbreviations: CDI: Clostridium difficile infection; CI: confidence interval; EIA: enzyme immunoassay; HE: hepatic encephalopathy; HRS: hepatorenal syndrome; MELD: Model for End-Stage Liver Disease; OR: odds ratio; PPIs: proton pump inhibitors; SBP: spontaneous bacterial peritonitis.

Impact of clostridium difficile infection on short-term outcomes in hospitalized patients with hematologic malignancies: A national sample.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e18711-e18711
Author(s):  
Kahee A. Mohammed ◽  
Eric Adjei Boakye ◽  
Jiajing Chen ◽  
Nosayaba Osazuwa-Peters ◽  
Martin W. Schoen ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Hematologic Malignancies ◽  
National Sample ◽  
Hospitalized Patients ◽  
Short Term
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