Implementation of routine Clostridioides difficile infection (CDI) primary prophylaxis in lung transplant recipients.


Journal

Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240

Informations de publication

Date de publication:
09 2023
Historique:
revised: 09 07 2023
received: 24 01 2023
accepted: 11 07 2023
medline: 8 9 2023
pubmed: 21 7 2023
entrez: 21 7 2023
Statut: ppublish

Résumé

Lung transplant recipients are at an increased risk for Clostridioides difficile infection (CDI), and those who develop CDI post-transplant can have worsened outcomes including graft failure and death. We sought to describe the efficacy and safety of primary CDI prophylaxis with oral vancomycin among 86 adult lung transplant recipients. Overall, we observed a 9.3% (8/86) incidence of CDI among patients receiving prophylaxis, with the majority of infections occurring a median of 25 days after completion of prophylaxis. Furthermore, we observed a 4.7% incidence of VRE infection/colonization. Opportunities exist to optimize the duration of CDI prophylaxis to balance the benefits and risks in lung transplant recipients.

Identifiants

pubmed: 37477286
doi: 10.1111/ctr.15079
doi:

Substances chimiques

Vancomycin 6Q205EH1VU
Anti-Bacterial Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e15079

Informations de copyright

© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Références

Nanayakkara D, Nanda N. Clostridium difficile infection in solid organ transplant recipients. Curr Opin Organ Transplant. 2017;22:314-319.
Gunderson C, Gupta M, Lopez F, et al. Clostridium difficile colitis in lung transplantation. Transpl Infect Dis. 2008;10:245-251.
Lee JT, Kelly RF, Hertz MI, Dunitz JM, Shumway SJ. Clostridium difficile infection increases mortality risk in lung transplant recipients. J Heart Lung Transplant. 2013;32(10):1020-1026.
Keven K, Basu A, Re L, et al. Clostridium difficile colitis in patients after kidney and pancreas-kidney transplantation. Transpl Infect Dis. 2004;6:10-14.
Bajrovic V, Budev M, McCurry KR, Brizendine KD. Vancomycin prophylaxis for Clostridium difficile infection among lung transplant recipients. J Heart Lung Transplant. 2019;38(8):874-876.
Isaac S, Scher JU, Djukovic A, et al. Short- and long-term effects of oral vancomycin on the human intestinal microbiota. J Antimicrob Chemother. 2017;72:128-136.
Johnson S, Lavergne V, Skinner AM, et al. Clinical practice guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 focused update guidelines on management of Clostridioides difficile infection in adults. Clin Infect Dis. 2021;73(5):e1029-e1044.
Stevens VW, Khader K, Echevarria K, et al. Use of oral vancomycin for clostridioides difficile infection and the risk of vancomycin-resistant enterococci. Clin Infect Dis. 2020;71(3):645-651.
Zaas A, Song X, Tucker P, Perl T. Risk factors for development of vancomycin-resistant enterococcal bloodstream infection in patients with cancer who are colonized with of vancomycin-resistant enterococci. Clin Infect Dis. 2002;35(10):1139-1146.
McFarlane A, Kabbani D, Smith S. Vancomycin-resistant Enterococci: differing rates and patterns of colonization in liver vs non-liver solid organ transplant. Open Forum Infect Dis. 2017 Fall;4(Suppl 1):S706-S707.

Auteurs

Mary Grace Fitzmaurice (MG)

Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Pharmacy and Transplant Institute, Henry Ford Health, Detroit, MI, USA.

Benjamin Hohlfelder (B)

Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.

Michael Rudoni (M)

Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA.

Kyle D Brizendine (KD)

Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA.

Marie Budev (M)

Department of Pulmonary, Allergy, and Critical Care Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

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