Incidence Rates and Risk Factors of Clostridioides difficile Infection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients
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Incidence Rates and Risk Factors of Clostridioides difficile Infection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients. / Ilett, Emma E; Helleberg, Marie; Reekie, Joanne; Murray, Daniel D; Wulff, Signe M; Khurana, Mark P.; Mocroft, Amanda; Daugaard, Gedske; Perch, Michael; Rasmussen, Allan; Sørensen, Søren S; Gustafsson, Finn; Frimodt-møller, Niels; Sengeløv, Henrik; Lundgren, Jens.
In: Open Forum Infectious Diseases, Vol. 6, No. 4, 01.04.2019.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Incidence Rates and Risk Factors of Clostridioides difficile Infection in Solid Organ and Hematopoietic Stem Cell Transplant Recipients
AU - Ilett, Emma E
AU - Helleberg, Marie
AU - Reekie, Joanne
AU - Murray, Daniel D
AU - Wulff, Signe M
AU - Khurana, Mark P.
AU - Mocroft, Amanda
AU - Daugaard, Gedske
AU - Perch, Michael
AU - Rasmussen, Allan
AU - Sørensen, Søren S
AU - Gustafsson, Finn
AU - Frimodt-møller, Niels
AU - Sengeløv, Henrik
AU - Lundgren, Jens
PY - 2019/4/1
Y1 - 2019/4/1
N2 - BackgroundTransplant recipients are an immunologically vulnerable patient group and are at elevated risk of Clostridioides difficile infection (CDI) compared with other hospitalized populations. However, risk factors for CDI post-transplant are not fully understood.MethodsAdults undergoing solid organ (SOT) and hematopoietic stem cell transplant (HSCT) from January 2010 to February 2017 at Rigshospitalet, University of Copenhagen, Denmark, were retrospectively included. Using nationwide data capture of all CDI cases, the incidence and risk factors of CDI were assessed.ResultsA total of 1687 patients underwent SOT or HSCT (1114 and 573, respectively), with a median follow-up time (interquartile range) of 1.95 (0.52–4.11) years. CDI was diagnosed in 15% (164) and 20% (114) of the SOT and HSCT recipients, respectively. CDI rates were highest in the 30 days post-transplant for both SOT and HSCT (adjusted incidence rate ratio [aIRR], 6.64; 95% confidence interval [CI], 4.37–10.10; and aIRR, 2.85; 95% CI, 1.83–4.43, respectively, compared with 31–180 days). For SOT recipients, pretransplant CDI and liver and lung transplant were associated with a higher risk of CDI in the first 30 days post-transplant, whereas age and liver transplant were risk factors in the later period. Among HSCT recipients, myeloablative conditioning and a higher Charlson Comorbidity Index were associated with a higher risk of CDI in the early period but not in the late period.ConclusionsUsing nationwide data, we show a high incidence of CDI among transplant recipients. Importantly, we also find that risk factors can vary relative to time post-transplant
AB - BackgroundTransplant recipients are an immunologically vulnerable patient group and are at elevated risk of Clostridioides difficile infection (CDI) compared with other hospitalized populations. However, risk factors for CDI post-transplant are not fully understood.MethodsAdults undergoing solid organ (SOT) and hematopoietic stem cell transplant (HSCT) from January 2010 to February 2017 at Rigshospitalet, University of Copenhagen, Denmark, were retrospectively included. Using nationwide data capture of all CDI cases, the incidence and risk factors of CDI were assessed.ResultsA total of 1687 patients underwent SOT or HSCT (1114 and 573, respectively), with a median follow-up time (interquartile range) of 1.95 (0.52–4.11) years. CDI was diagnosed in 15% (164) and 20% (114) of the SOT and HSCT recipients, respectively. CDI rates were highest in the 30 days post-transplant for both SOT and HSCT (adjusted incidence rate ratio [aIRR], 6.64; 95% confidence interval [CI], 4.37–10.10; and aIRR, 2.85; 95% CI, 1.83–4.43, respectively, compared with 31–180 days). For SOT recipients, pretransplant CDI and liver and lung transplant were associated with a higher risk of CDI in the first 30 days post-transplant, whereas age and liver transplant were risk factors in the later period. Among HSCT recipients, myeloablative conditioning and a higher Charlson Comorbidity Index were associated with a higher risk of CDI in the early period but not in the late period.ConclusionsUsing nationwide data, we show a high incidence of CDI among transplant recipients. Importantly, we also find that risk factors can vary relative to time post-transplant
U2 - 10.1093/ofid/ofz086
DO - 10.1093/ofid/ofz086
M3 - Journal article
C2 - 30949533
VL - 6
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
SN - 2328-8957
IS - 4
ER -
ID: 233724343