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The epidemiology of Clostridium difficile infection in a national kidney transplant center
Author(s) -
Kennedy Claire,
Waldron Carmel,
Skally Mairead,
Gaughan Leah,
Magee Colm,
Burns Karen,
Fitzpatrick Fidelma
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12962
Subject(s) - medicine , clostridium difficile , epidemiology , antimicrobial stewardship , kidney transplant , intensive care medicine , kidney transplantation , single center , kidney disease , emergency medicine , pediatrics , transplantation , antibiotics , antibiotic resistance , microbiology and biotechnology , biology
Background We aimed to describe the epidemiology and outcomes of CDI in a national kidney transplant center from 2008 to 2015. Methods Adult kidney and kidney‐pancreas transplant recipients were included for analysis if they met the surveillance CDI case definition. Rates of new healthcare‐associated CDI ( HA ‐ CDI ) were expressed per 10 000 KTR / KTPR bed days used ( BDU ) to facilitate comparisons. Results Fifty‐two cases of CDI were identified in 42 KTR s and KPTR s. This corresponded to an average annual rate of 9.6 per 10 000 BDU , higher than that seen among general hospital inpatients locally, nationally, and internationally. Of the 45 cases (87%) that were considered HA ‐ CDI , nine (20%) had symptom onset in the community. Recent proton‐pump inhibitor ( PPI ) and broad‐spectrum antimicrobial exposure preceded the majority of cases. KTR s and KPTR s with CDI had a longer mean length of hospital stay (35 days) than those KTR and KPTR s admitted during the same period that did not have CDI (8 days). Conclusions Education regarding CDI must be extended to transplant recipients and their general practitioners. Other targets for future CDI rate reduction must include stringent antimicrobial stewardship (both in hospital and in the community) and judicious PPI prescribing.