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Prospective assessment of Clostridioides (formerly Clostridium) difficile colonization and acquisition in hematopoietic stem cell transplant patients.
Austin, Kristin; Sweet, Michael; Likar, Eric; LaSala, P Rocco; Murray, Amanda; Wen, Sijin; Ross, Kelly G; Kanate, Abraham S; Veltri, Lauren; Matuga, Rebekah; Cumpston, Aaron.
Afiliação
  • Austin K; Department of Pharmacy, West Virginia University Medicine, Morgantown, WV, USA.
  • Sweet M; Center for Quality Outcomes, West Virginia University Medicine, Morgantown, WV, USA.
  • Likar E; Department of Pharmacy, West Virginia University Medicine, Morgantown, WV, USA.
  • LaSala PR; Department of Pathology, West Virginia University Medicine, Morgantown, WV, USA.
  • Murray A; Department of Microbiology, West Virginia University Medicine, Morgantown, WV, USA.
  • Wen S; Department of Biostatistics, West Virginia University, Morgantown, WV, USA.
  • Ross KG; Osborn Hematopoietic Malignancy and Transplantation Program, MBRCC, West Virginia University, Morgantown, WV, USA.
  • Kanate AS; Osborn Hematopoietic Malignancy and Transplantation Program, MBRCC, West Virginia University, Morgantown, WV, USA.
  • Veltri L; Osborn Hematopoietic Malignancy and Transplantation Program, MBRCC, West Virginia University, Morgantown, WV, USA.
  • Matuga R; Department of Pharmacy, West Virginia University Medicine, Morgantown, WV, USA.
  • Cumpston A; Department of Pharmacy, West Virginia University Medicine, Morgantown, WV, USA.
Transpl Infect Dis ; 22(6): e13438, 2020 Dec.
Article em En | MEDLINE | ID: mdl-32767807
ABSTRACT

BACKGROUND:

Patients undergoing hematopoietic stem cell transplant (HSCT) possess numerous risk factors for Clostridioides (formerly Clostridium) difficile infection (CDI) and experience a high rate of diarrhea. Colonization rates of Clostridium difficile vary greatly among subgroup analyses with recent studies demonstrating colonization rates in the blood and marrow transplant units up to nine times that of the general population.

METHODS:

The primary objectives of this study were to identify the rate of C difficile colonization and acquisition in HSCT patients admitted to the blood and marrow transplant unit. This was a prospective study that included all adult patients admitted for hematopoietic stem cell transplantation. Stool specimens were routinely collected on admission and weekly thereafter for a maximum of six samples per patient.

RESULTS:

Forty-two patients met inclusion criteria and had baseline samples available for analysis. The rate of C difficile colonization on admission was 24%, and an additional 9% of patients acquired the organism during admission. Twelve percent of patients developed CDI that was diagnosed clinically. Univariate analysis showed an increased risk of colonization for patients with three or more prior chemotherapy cycles.

CONCLUSIONS:

Given high colonization rates coupled with high risk of CDI in this population, providers must be judicious when testing for CDI and interpreting test results for HSCT patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Clostridioides difficile / Infecções por Clostridium / Transplante de Células-Tronco Hematopoéticas Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Transpl Infect Dis Assunto da revista: TRANSPLANTE Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Clostridioides difficile / Infecções por Clostridium / Transplante de Células-Tronco Hematopoéticas Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Transpl Infect Dis Assunto da revista: TRANSPLANTE Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos