Clostridium difficile-associated disease in allogeneic hematopoietic stem-cell transplant recipients: risk associations, protective associations, and outcomes.
Erik R. Dubberke,Kimberlay A. Reske,Anand Srivastava,Justin S. Sadhu,Robert Gatti,Rebecca M. Young,Lauren C. Rakes,Brian K. Dieckgraefe,John F. DiPersio,Victoria J. Fraser +9 more
TLDR
Clostridium difficile‐associated disease in allogeneic hematopoietic stem‐cell transplant recipients: risk associations, protective associations, and outcomes.Abstract:
The purpose of this study was to evaluate risk factors, protective factors, and outcomes associated with Clostridium difficile-associated disease (CDAD) in allogeneic hematopoietic stem-cell transplant (HSCT) recipients. A case-control study was performed with 37 CDAD cases and 67 controls. In the multivariable logistic regression analysis, receipt of a third or fourth generation cephalosporin was associated with increased risk of CDAD (OR = 4.6, 95% CI 1.6-13.1). Receipt of growth factors was associated with decreased risk of CDAD (OR=0.1, 95% CI 0.02-0.3). Cases were more likely to develop a blood stream infection after CDAD than were controls at any point before discharge (p < 0.001). CDAD cases were more likely than controls to develop new onset graft-vs.-host disease (GVHD) (p < 0.001), new onset severe GVHD (p < 0.001), or new onset gut GVHD (p = 0.007) after CDAD/discharge. Severe CDAD was a risk factor for death at 180 d in multivariable Cox proportional hazards regression (HR=2.6, 95% CI 1.1-6.2). CDAD is a significant cause of morbidity and mortality in allogeneic HSCT patients, but modifiable risk factors exist. Further study is needed to determine the best methods of decreasing patients' risk of CDAD.read more
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Diagnosis of Clostridium difficile Infection: an Ongoing Conundrum for Clinicians and for Clinical Laboratories
TL;DR: This review provides an in-depth discussion of the laboratory methods used for the diagnosis of C. difficile infection (CDI), and the evolving epidemiology of colonization and infection with this organism are discussed.
Journal ArticleDOI
Innate Immune Defenses Mediated by Two ILC Subsets Are Critical for Protection against Acute Clostridium difficile Infection.
Michael C. Abt,Brittany B. Lewis,Silvia Caballero,Huizhong Xiong,Rebecca A. Carter,Bože Sušac,Lilan Ling,Ingrid Leiner,Eric G. Pamer +8 more
TL;DR: A critical role for ILC1s in defense against C. difficile is demonstrated and protection against infection was restored by transferring ILCs into Ragγc(-/-) mice.
Journal ArticleDOI
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 A. Marr +6 more
TL;DR: Early timing of CDI after HSCT suggests that the natural history of disease in some patients may involve colonization prior to HSCT, and a potentially important interplay between CDI and GVHD involving the gastrointestinal tract was observed.
Journal ArticleDOI
Fecal microbiota transplantation for fulminant Clostridium difficile infection in an allogeneic stem cell transplant patient.
Kari Neemann,D. D D Eichele,P. P W Smith,Robert G. Bociek,Mojtaba Akhtari,Alison G. Freifeld +5 more
TL;DR: This case of severe Clostridium difficile infection in a non‐neutropenic allogeneic hematopoietic stem cell transplant recipient who was treated successfully with fecal microbiota therapy after standard pharmacologic therapy had failed is presented.
Journal ArticleDOI
Recent epidemiology of Clostridium difficile infection during hematopoietic stem cell transplantation.
Teena Chopra,Pranatharthi H. Chandrasekar,Hossein Salimnia,Lance K. Heilbrun,Daryn Smith,George Alangaden +5 more
TL;DR: It is necessary to select patients suitable for hematopoietic stem cell transplantation for Clostridium difficile infection based on prior history and once they provide informed consent for the procedure, says Chopra.
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A Comparison of Vancomycin and Metronidazole for the Treatment of Clostridium difficile–Associated Diarrhea, Stratified by Disease Severity
TL;DR: The findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild CDAD, but vancomYcin is superior for treating patients with severe CDAD.
Journal ArticleDOI
Total body irradiation and acute graft-versus-host disease: The role of gastrointestinal damage and inflammatory cytokines
Geoffrey R. Hill,Geoffrey R. Hill,James M. Crawford,James M. Crawford,Kenneth R. Cooke,Kenneth R. Cooke,Yani S. Brinson,Yani S. Brinson,Luying Pan,Luying Pan,James L.M. Ferrara,James L.M. Ferrara +11 more
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