PMID- 25076434
OWN - NLM
STAT- MEDLINE
DCOM- 20141003
LR  - 20220409
IS  - 1678-9946 (Electronic)
IS  - 0036-4665 (Print)
IS  - 0036-4665 (Linking)
VI  - 56
IP  - 4
DP  - 2014 Jul-Aug
TI  - Incidence of diarrhea by Clostridium difficile in hematologic patients and 
      hematopoietic stem cell transplantation patients: risk factors for severe forms 
      and death.
PG  - 325-31
LID - S0036-46652014000400325 [pii]
AB  - We describe the rate of incidence of Clostridium difficile-associated diarrhea 
      (CDAD) in hematologic and patients undergone stem cell transplant (HSCT) at 
      HC-FMUSP, from January 2007 to June 2011, using two denominators 1,000 patient 
      and 1,000 days of neutropenia and the risk factors associated with the severe 
      form of the disease and death. The ELISA method (Ridascreen-Biopharm, Germany) 
      for the detections of toxins A/B was used to identify C. difficile. A 
      multivariate analysis was performed to evaluate potential factors associated with 
      severe CDAD and death within 14 days after the diagnosis of CDAD, using multiple 
      logistic regression. Sixty-six episodes were identified in 64 patients among 439 
      patients with diarrhea during the study period. CDA rate of incidence varied from 
      0.78 to 5.45 per 1,000 days of neutropenia and from 0.65 to 5.45 per 1,000 
      patient-days. The most common underlying disease was acute myeloid leukemia 30/64 
      (44%), 32/64 (46%) patients were neutropenic, 31/64 (45%) undergone allogeneic 
      HSCT, 61/64 (88%) had previously used antibiotics and 9/64 (13%) have severe 
      CDAD. Most of the patients (89%) received treatment with oral metronidazole and 
      19/64 (26%) died. The independent risk factors associated with death were the 
      severe form of CDAD, and use of linezolid.
FAU - Spadao, Fernanda
AU  - Spadao F
AD  - Hospital das Clinicas, University of Sao Paulo, Sao Paulo, SP, Brazil.
FAU - Gerhardt, Juliana
AU  - Gerhardt J
AD  - Hospital das Clinicas, University of Sao Paulo, Sao Paulo, SP, Brazil.
FAU - Guimaraes, Thais
AU  - Guimaraes T
AD  - Hospital das Clinicas, University of Sao Paulo, Sao Paulo, SP, Brazil.
FAU - Dulley, Frederico
AU  - Dulley F
AD  - Hospital das Clinicas, Bone Marrow Transplant Unit, University of Sao Paulo, Sao 
      Paulo, SP, Brazil.
FAU - Almeida Junior, Joao Nobrega de
AU  - Almeida Junior JN
AD  - Laboratory of Microbiology, Hospital das Clinicas of University, Sao Paulo, Sao 
      Paulo, SP, Brazil.
FAU - Batista, Marjorie Vieira
AU  - Batista MV
AD  - Infectious Diseases Department, Unversity of Sao Paulo, Brazil.
FAU - Shikanai-Yasuda, Maria Aparecida
AU  - Shikanai-Yasuda MA
AD  - Infectious Diseases Department, Unversity of Sao Paulo, Brazil.
FAU - Levin, Anna Sara
AU  - Levin AS
AD  - Infectious Diseases Department, Unversity of Sao Paulo, Brazil.
FAU - Costa, Silvia Figueiredo
AU  - Costa SF
AD  - Infectious Diseases Department, Unversity of Sao Paulo, Brazil.
LA  - eng
PT  - Journal Article
PL  - Brazil
TA  - Rev Inst Med Trop Sao Paulo
JT  - Revista do Instituto de Medicina Tropical de Sao Paulo
JID - 7507484
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Brazil/epidemiology
MH  - Child
MH  - *Clostridioides difficile
MH  - Diarrhea/*mortality
MH  - Enterocolitis, Pseudomembranous/*mortality
MH  - Female
MH  - *Hematologic Diseases
MH  - *Hematopoietic Stem Cell Transplantation/mortality
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Young Adult
PMC - PMC4131819
EDAT- 2014/07/31 06:00
MHDA- 2014/10/04 06:00
PMCR- 2014/07/01
CRDT- 2014/07/31 06:00
PHST- 2013/04/18 00:00 [received]
PHST- 2014/01/07 00:00 [accepted]
PHST- 2014/07/31 06:00 [entrez]
PHST- 2014/07/31 06:00 [pubmed]
PHST- 2014/10/04 06:00 [medline]
PHST- 2014/07/01 00:00 [pmc-release]
AID - S0036-46652014000400325 [pii]
AID - S0036-46652014000400010 [pii]
AID - 10.1590/s0036-46652014000400010 [doi]
PST - ppublish
SO  - Rev Inst Med Trop Sao Paulo. 2014 Jul-Aug;56(4):325-31. doi: 
      10.1590/s0036-46652014000400010.