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Clostridium difficile Infection in Intestinal Transplant Recipients.

V. Goldenberg,1 A. Berbel,2 J. Camargo,1 J. Simkins.1

1Medicine, Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL
2Medicine, University of Miami Miller School of Medicine, Miami, FL

Meeting: 2017 American Transplant Congress

Abstract number: B90

Keywords: Bacterial infection, Infection, Intestinal transplantation, Outcome

Session Information

Session Name: Poster Session B: Bacteria, Fungi, Parasites

Session Type: Poster Session

Date: Sunday, April 30, 2017

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Background: Clostridium difficile infection (CDI) data in intestinal transplant (ITx) recipients is lacking. This study was performed to evaluate prevalence, risk factors, treatments and outcomes of CDI in ITx recipients.

Methods: Retrospective study of adult and pediatric patients who underwent ITx (isolated or multi-visceral) between 1/2013 and 12/2015 at Jackson Memorial Hospital. Those who developed CDI within a year after ITx were considered cases. We evaluated if there were any differences in demographics, antibiotics or proton-pump inhibitors (PPI) use within 90 days prior and after ITx and one-year posttransplant survival between cases and controls. In addition, we assessed for severe CDI (WBC >15×103/mcl, creatinine >1.5 x baseline or pseudomembranes), CDI treatments and outcomes.

Results: 10/51 (20%) ITx recipients developed CDI. There were no differences in demographics, antibiotics or PPI use and one-year survival between groups [Table1]. The mean time from ITx to CDI diagnosis was 209±88.9 days. Four cases were severe. Vancomycin was given to two patients, and metronidazole and combined metronidazole/vancomycin to four each. None had colectomy, died from CDI or had recurrences within 12 weeks after being treated for CDI.

Conclusions: CDI was common in our ITx recipients and it was not associated with adverse outcomes. Larger studies are needed.

Variables CDI-pos

N[ordm] 10 (%)

CDI-neg

N[ordm] 41 (%)

P-value
Age (years) 26.7±22.3 29.3±23.4 0.75
Gender (female) 4(40) 22(54) 0.50
Antibiotic exposure 10(100) 39(95) >0.99
Quinolones 2(20) 12(29) 0.71
Clindamycin 1(10) 2(5) 0.49
3rdand 4thgeneration cephalosporins 8(80) 30(73) >0.99
Carbapenems 5(50) 21(51) 0.94
Beta-lactamase inhibitors 4(40) 19(46) >0.99
Aztreonam 0 2(5) >0.99
Tigecycline 1(10) 3(7) >0.99
Number of days of antibiotics 31.6±11.3 50.4±41 0.16
≥ 2 groups of antibiotics 7(70) 27(66) >0.99
PPI 9(90) 40(98) 0.36
Survival at one-year posttransplant 10(100) 30(73) 0.09

CITATION INFORMATION: Goldenberg V, Berbel A, Camargo J, Simkins J. Clostridium difficile Infection in Intestinal Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

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To cite this abstract in AMA style:

Goldenberg V, Berbel A, Camargo J, Simkins J. Clostridium difficile Infection in Intestinal Transplant Recipients. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/clostridium-difficile-infection-in-intestinal-transplant-recipients/. Accessed May 9, 2025.

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