Epidemiology, risk factors, and outcomes of Clostridium difficile infection in kidney transplant recipients.
Transpl Infect Dis
; 15(2): 134-41, 2013 Apr.
Article
em En
| MEDLINE
| ID: mdl-23173772
ABSTRACT
BACKGROUND:
We sought to describe the epidemiology and risk factors for Clostridium difficile infection (CDI) among kidney transplant recipients (KTR) between 1 January 2008 and 31 December 2010.METHODS:
A single-institution retrospective study was conducted among all adult KTR with CDI, defined as a positive test for C. difficile by a cell cytotoxic assay for C. difficile toxin A or B or polymerase chain reaction test for toxigenic C. difficile.RESULTS:
Among 603 kidney transplants performed between 1 January 2008 and 31 December 2010, 37 (6.1%) patients developed CDI 12 (of 128; 9.4%) high-risk (blood group incompatible and/or anti-human leukocyte antigen donor-specific antibodies) vs. 25 (of 475; 5.3%, P = 0.08) standard-risk patients. The overall rate of CDI increased from 3.7% in 2008 to 9.4% in 2010 (P = 0.05). The median time to CDI diagnosis was 9 days, with 27 (73.0%) patients developing CDI within the first 30 days after their transplant, and 14 (51.8%) developing CDI within 7 days. A case-control analysis of 37 CDI cases and 74 matched controls demonstrated the following predictors for CDI among KTR vancomycin-resistant Enterococcus colonization before transplant (odds ratio [OR] 3.6, P = 0.03), receipt of an organ from Centers for Disease Control high-risk donor (OR 5.9, P = 0.006), and administration of high-risk antibiotics within 30 days post transplant (OR 6.6, P = 0.001).CONCLUSIONS:
CDI remains a common early complication in KTR, with rates steadily increasing during the study period. Host and transplant-related factors and exposure to antibiotics appeared to significantly impact the risk for CDI among KTR.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Transplante de Rim
/
Infecções por Clostridium
/
Antibacterianos
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article