Outcome of Clostridium difficile-associated disease in solid organ transplant recipients: a prospective and multicentre cohort study
Por:
Len, O, Rodriguez-Pardo, D, Gavalda, J, Aguado, JM, Blanes, M, Borrell, N, Bou, G, Carratala, J, Cisneros, JM, Fortun, J, Gurgui, M, Montejo, M, Cervera, C, Munoz, P, Asensio, A, Torre-Cisneros, J, Pahissa, A
Publicada:
1 dic 2012
Resumen:
Clostridium difficile-associated disease (CDAD) is the most common cause of nosocomial diarrhea. Information about CDAD in solid organ transplant (SOT) recipients is scarce. To determine its epidemiology and risk factors, we conducted a cohort study in which 4472 SOT patients were prospectively included in the RESITRA/REIPI (Spanish Research Network for the Study of Infection in Transplantation) database between July 2003 and July 2006. Forty-two episodes of CDAD were diagnosed in 36 patients. The overall incidence was 0.94%. Median onset of infection was 31.5 days (range 6741); in half the cases, onset occurred during the first month after transplantation. In 26% of cases, there was no previous antibiotic use. Independent risk factors for CDAD using Cox regression analysis were previous use of first- and second-generation cephalosporins (HR 3.68; 95%CI 1.87.52; P < 0.001), ganciclovir prophylactic use (HR 3.09; 95%CI 1.446.62; P = 0.004) and corticosteroid use before transplantation (HR 2.95; 95%CI 1.17.9; P = 0.031). There were no deaths related to CDAD. In summary, the incidence of CDAD in SOT was low, most cases were diagnosed soon after transplantation and the prognosis was good.
Filiaciones:
Len, O:
Hosp Valle De Hebron, Dept Infect Dis, Barcelona, Spain
Rodriguez-Pardo, D:
Hosp Valle De Hebron, Dept Infect Dis, Barcelona, Spain
Gavalda, J:
Hosp Valle De Hebron, Dept Infect Dis, Barcelona, Spain
Aguado, JM:
Hosp 12 Octubre, Infect Dis Unit, E-28041 Madrid, Spain
Blanes, M:
Hosp La Fe, Infect Dis Unit, E-46009 Valencia, Spain
Borrell, N:
Hosp Son Espases, Dept Microbiol, Palma de Mallorca, Spain
Bou, G:
Hosp Juan Canalejo, Dept Microbiol, La Coruna, Spain
Carratala, J:
Bellvitge Hosp, Dept Infect Dis, Barcelona, Spain
Cisneros, JM:
Hosp Virgen del Rocio, Dept Infect Dis, Seville, Spain
Fortun, J:
Hosp Ramon & Cajal, Dept Infect Dis, E-28034 Madrid, Spain
Gurgui, M:
Hosp Santa Creu & Sant Pau, Infect Dis Unit, Barcelona, Spain
Montejo, M:
Hosp Cruces, Infect Dis Unit, Baracaldo, Spain
Cervera, C:
Hosp Clin Barcelona, Dept Infect Dis, Barcelona, Spain
Munoz, P:
Hosp Gen Gregorio Maranon, Dept Microbiol, Madrid, Spain
Asensio, A:
Hosp Puerta de Hierro, Dept Prevent Med, Madrid, Spain
Torre-Cisneros, J:
Hosp Reina Sofia, Dept Infect Dis, Cordoba, Spain
Pahissa, A:
Hosp Valle De Hebron, Dept Infect Dis, Barcelona, Spain
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