Epidemiology and outcomes of clostridium difficile infections in hematopoietic stem cell transplant recipients

Carolyn D. Alonso, Suzanne B. Treadway, David B. Hanna, Carol Ann Huff, Dionissios Neofytos, Karen C Carroll, Kieren Marr

Research output: Contribution to journalArticle

Abstract

Background. Clostridium difficile is the leading cause of infectious diarrhea among hospitalized patients and is a major concern for patients undergoing hematopoietic stem cell transplantation (HSCT). Risk factors and the natural history of C. difficile infection (CDI) are poorly understood in this population.Methods.We performed a retrospective nested case-control study to describe the epidemiology, timing, and risk factors for CDI among adult patients who received HSCTs at our center from January 2003 through December 2008. Results. The overall 1-year incidence of CDI was 9.2% among HSCTs performed (n=999). The median time to diagnosis of CDI was short among both autologous and allogeneic HSCT recipients (6.5 days and 33 days, respectively). Risk factors for CDI in allogeneic HSCT recipients included receipt of chemotherapy prior to conditioning for HSCT, broad-spectrum antimicrobial use, and acute graft-versus-host disease (GVHD; adjusted odds ratio [AOR], 4.45; 95% confidence interval [CI], 1.54-12.84; P=.006). There was a strong relationship between early CDI and subsequent development of gastrointestinal tract GVHD in the year following allogeneic HSCT (P

Original languageEnglish (US)
Pages (from-to)1053-1063
Number of pages11
JournalClinical Infectious Diseases
Volume54
Issue number8
DOIs
StatePublished - Apr 15 2012

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Clostridium Infections
Clostridium difficile
Hematopoietic Stem Cells
Epidemiology
Hematopoietic Stem Cell Transplantation
Transplants
Graft vs Host Disease
Transplant Recipients
Gastrointestinal Tract
Case-Control Studies
Diarrhea
Odds Ratio
Confidence Intervals
Drug Therapy
Incidence

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

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Epidemiology and outcomes of clostridium difficile infections in hematopoietic stem cell transplant recipients. / Alonso, Carolyn D.; Treadway, Suzanne B.; Hanna, David B.; Huff, Carol Ann; Neofytos, Dionissios; Carroll, Karen C; Marr, Kieren.

In: Clinical Infectious Diseases, Vol. 54, No. 8, 15.04.2012, p. 1053-1063.

Research output: Contribution to journalArticle

Alonso, Carolyn D. ; Treadway, Suzanne B. ; Hanna, David B. ; Huff, Carol Ann ; Neofytos, Dionissios ; Carroll, Karen C ; Marr, Kieren. / Epidemiology and outcomes of clostridium difficile infections in hematopoietic stem cell transplant recipients. In: Clinical Infectious Diseases. 2012 ; Vol. 54, No. 8. pp. 1053-1063.
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