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A multicenter study to define the epidemiology and outcomes of Clostridioides difficile infection in pediatric hematopoietic cell and solid organ transplant recipients.
Mayer, Erick F; Maron, Gabriela; Dallas, Ronald H; Ferrolino, Jose; Tang, Li; Sun, Yilun; Danziger-Isakov, Lara; Paulsen, Grant C; Fisher, Brian T; Vora, Surabhi B; Englund, Janet; Steinbach, William J; Michaels, Marian; Green, Michael; Yeganeh, Nava; Gibson, Joy E; Dominguez, Samuel R; Nicholson, Maribeth R; Dulek, Daniel E; Ardura, Monica I; Rajan, Sujatha; Gonzalez, Blanca E; Beneri, Christy; Herold, Betsy C.
Afiliación
  • Mayer EF; Department of Pediatrics, Albert Einstein College of Medicine and Children's Hospital at Montefiore, Bronx, New York, USA.
  • Maron G; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Dallas RH; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Ferrolino J; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Tang L; Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Sun Y; Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Danziger-Isakov L; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
  • Paulsen GC; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
  • Fisher BT; Division of Infectious Diseases and Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
  • Vora SB; Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA.
  • Englund J; Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington, USA.
  • Steinbach WJ; Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA.
  • Michaels M; Department of Pediatrics & Surgery, Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Green M; Department of Pediatrics & Surgery, Division of Infectious Diseases, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
  • Yeganeh N; Department of Pediatrics, UCLA Mattel Children's Hospital, Los Angeles, California, USA.
  • Gibson JE; Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA.
  • Dominguez SR; Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA.
  • Nicholson MR; Department of Pediatrics, Monroe Carell Jr Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Dulek DE; Department of Pediatrics, Monroe Carell Jr Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Ardura MI; Department of Pediatrics & Host Defense Program, Nationwide Children's Hospital, Columbus, Ohio, USA.
  • Rajan S; Cohen Children's Medical Center, Northwell Health, New Hyde Park, New York, USA.
  • Gonzalez BE; Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA.
  • Beneri C; Department of Pediatric, Stony Brook School of Medicine, Stony Brook, New York, USA.
  • Herold BC; Department of Pediatrics, Albert Einstein College of Medicine and Children's Hospital at Montefiore, Bronx, New York, USA.
Am J Transplant ; 20(8): 2133-2142, 2020 08.
Article en En | MEDLINE | ID: mdl-32064754
Hematopoietic cell transplant (HCT) and solid organ transplant (SOT) recipients are at increased risk for Clostridioides difficile infection (CDI). We conducted a multicenter retrospective study to describe the incidence of CDI in children transplanted between January 2010 and June 2013. Nested case-control substudies, matched 1:1 by transplant type, institution, patient age, and time of year (quartile) of transplant, identified CDI risk factors. Cohorts included 1496 HCT and 1090 SOT recipients. Among HCT recipients, 355 CDI episodes were diagnosed in 265 recipients (18.2%). Nested case-control study identified prior history of CDI (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.5-4.7), proton pump inhibitors (PPIs; OR 2.1, 95% CI 1.3-3.4), and exposure to third- (OR 2.4, 95% CI 1.4-4.2) or fourth-generation (OR 2.1, 95% CI 1.2-3.7) cephalosporins as risk factors. Notably, fluoroquinolone exposure appeared protective (OR 0.6, 95% CI 0.3-0.9). Ninety-two episodes of CDI were diagnosed among 79 SOT recipients (7.3%), and exposure to PPIs (OR 2.4, 95% CI 1.1-5.4) and third-generation cephalosporin therapy (OR 3.9, 95% CI 1.4-10.5) were identified as risk factors. Strategies to decrease PPI use and changes in the class of prophylactic antibiotics may impact CDI incidence and warrant further study.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clostridioides difficile / Trasplante de Órganos / Infecciones por Clostridium / Trasplante de Células Madre Hematopoyéticas Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Child / Humans Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clostridioides difficile / Trasplante de Órganos / Infecciones por Clostridium / Trasplante de Células Madre Hematopoyéticas Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Child / Humans Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos