Introduction:

Clostridium difficile infection(CDI) is one of the leading infectious causes among solid organ transplant (SOT) recipients. While the recurrence rate is relatively high, clinical outcomes of recurrent episodes of CDI in SOT recipients have not been well assessed. In this study, we evaluated the outcomes of recurrent CDI, and compared them with those of first episodes of CDI without recurrence in SOT recipients.

Methods:

SOT recipients transplanted at our center with Clostridium difficile positive PCR (Cepheid Xpert) from January 2011 to October 2016 were identified. Data pertaining to the first recurrent episodes of CDI as well as to the first episodes of CDI without recurrence were collected. Recurrence was defined as onset of symptoms of CDI within 8 weeks after completing appropriate initial treatment, accompanied by positive PCR.

Results:

41 episodes of first recurrent CDI and 167 episodes of first CDI without recurrence were identified. The median age of the cohorts CDI diagnosis were and 58 (range 21 to 73) years and 57 (range 20 to 81) years, respectively. Transplant types of the recurrent CDI cohort were kidney (n=12), liver (n=10), lung (n=10), heart (n=4), heart/lung (n=1), kidney/pancreas (n=1), liver/kidney (n=1), PAK (n=1) and intestine (n=1). Recurrent CDI cases were similar to no recurrent cases in respect to severity of the disease. None of the recurrent cases had surgical intervention. The outcomes associated with recurrent CDI are listed in Table 1.Conclusions:

SOT recipients with recurrent CDI had higher rate of readmissions with shorter hospital and ICU length of stay. All-cause thirty days mortality was similar between SOT recipients with recurrent and no recurrent CDI.

CITATION INFORMATION: Shiotsuka M, Natori Y, Kumar D, Humar A, Rotstein C, Husain S. Outcomes of Recurrent Clostridium difficile Infection in Solid Organ Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

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