PMID- 29427406
OWN - NLM
STAT- MEDLINE
DCOM- 20180917
LR  - 20180917
IS  - 1399-3062 (Electronic)
IS  - 1398-2273 (Linking)
VI  - 20
IP  - 2
DP  - 2018 Apr
TI  - Risk factors for Clostridium difficile infection in intestinal transplant 
      recipients during the first year post-transplant.
PG  - e12858
LID - 10.1111/tid.12858 [doi]
AB  - BACKGROUND: Clostridium difficile is the most common cause of 
      healthcare-associated infectious diarrhea. Risk factors for C. difficile 
      infections (CDI) in intestinal transplant recipients (ITR) are not well-defined. 
      The aim of our study was to assess specific risk factors for CDI in ITR. METHODS: 
      This is a 1:3 case-control study that included 29 ITR who developed CDI (cases) 
      and 87 ITR without CDI (controls) observed during the first year 
      post-transplantation. Wilcoxon rank sum and Fisher's exact tests were used to 
      compare variables. Univariate and multivariable conditional logistic regressions 
      analysis were performed to identify risk factors for CDI. RESULTS: The 
      multivariable conditional logistic regression analysis showed that proton pump 
      inhibitors (PPI) administration (odds ratio [OR] = 0.06; 95% confidence interval 
      [CI]: 0.007-0.52; P = .01) was the only factor associated with lower rates of 
      CDI. Outcomes for cases vs controls: rejection episodes 24.14% vs 20.69% 
      (P = .7), graft loss 0% vs 2.3% (P = .99), and survival rate 1 year 
      post-transplantation 79.3% (59.6-90.1%) vs 87.2% (78.1-92.7%) (P = .38). 
      CONCLUSIONS: Proton pump inhibitor administration might be protective for CDI in 
      ITR. Risks factors for CDI might be different in ITR compared to other 
      populations; anatomical differences and medications administered in the 
      post-transplantation period may affect intestinal microbiota.
CI  - (c) 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Guzman, L
AU  - Guzman L
AD  - Infectious Diseases Division, University of Nebraska Medical Center, Omaha, NE, 
      USA.
FAU - Qiu, F
AU  - Qiu F
AD  - College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
FAU - Kalil, A C
AU  - Kalil AC
AD  - Infectious Diseases Division, University of Nebraska Medical Center, Omaha, NE, 
      USA.
FAU - Mercer, D F
AU  - Mercer DF
AD  - Transplant Surgery Division, University of Nebraska Medical Center, Omaha, NE, 
      USA.
FAU - Langnas, A
AU  - Langnas A
AD  - Transplant Surgery Division, University of Nebraska Medical Center, Omaha, NE, 
      USA.
FAU - Florescu, D F
AU  - Florescu DF
AUID- ORCID: 0000-0003-2776-1355
AD  - Infectious Diseases Division, University of Nebraska Medical Center, Omaha, NE, 
      USA.
AD  - Transplant Surgery Division, University of Nebraska Medical Center, Omaha, NE, 
      USA.
LA  - eng
PT  - Journal Article
DEP - 20180306
PL  - Denmark
TA  - Transpl Infect Dis
JT  - Transplant infectious disease : an official journal of the Transplantation 
      Society
JID - 100883688
SB  - IM
MH  - Adolescent
MH  - Case-Control Studies
MH  - Child
MH  - Child, Preschool
MH  - Clostridium Infections/*drug therapy/*etiology
MH  - Female
MH  - Humans
MH  - Infant
MH  - Intestines/*transplantation
MH  - Male
MH  - Organ Transplantation/*adverse effects
MH  - Postoperative Complications
MH  - Retrospective Studies
MH  - Risk Factors
MH  - *Transplant Recipients
OTO - NOTNLM
OT  - Clostridium difficile
OT  - diarrhea
OT  - enteritis
OT  - intestinal transplant
OT  - risk factors
EDAT- 2018/02/11 06:00
MHDA- 2018/09/18 06:00
CRDT- 2018/02/11 06:00
PHST- 2017/03/29 00:00 [received]
PHST- 2017/08/14 00:00 [revised]
PHST- 2017/10/07 00:00 [accepted]
PHST- 2018/02/11 06:00 [pubmed]
PHST- 2018/09/18 06:00 [medline]
PHST- 2018/02/11 06:00 [entrez]
AID - 10.1111/tid.12858 [doi]
PST - ppublish
SO  - Transpl Infect Dis. 2018 Apr;20(2):e12858. doi: 10.1111/tid.12858. Epub 2018 Mar 
      6.