ArticleBiology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation2014
Clostridium difficile infection after allogeneic hematopoietic stem cell transplant: strain diversity and outcomes associated with NAP1/027.
Article in Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Prevalence ofFrontiers in cellular and infection microbiology · 2022Pooled it
- Management ofEClinicalMedicine · 2025Review
- Effective treatment of Clostridioides difficile infection improves survival and affects graft-versus-host disease: a multicenter study by the Polish Adult Leukemia Group.Scientific reports · 2024Article
- Epidemiology, outcomes and risk factors for recurrence of Clostridioides difficile infections following allogeneic hematopoietic cell transplantation: a longitudinal retrospective multicenter study.Bone marrow transplantation · 2024Article
- Intestinal barrier functions in hematologic and oncologic diseases.Journal of translational medicine · 2023Review
- Fecal Microbiota Transplant for Hematologic and Oncologic Diseases: Principle and Practice.Cancers · 2022Review
- ToxigenicEpidemiology and infection · 2021Article
- Risk Factors and Outcome ofJournal of clinical medicine · 2020Article
- Clostridium Difficile infections in patients with AML or MDS undergoing allogeneic hematopoietic stem cell transplantation identify high risk for adverse outcome.Bone marrow transplantation · 2020Article
- A Single-Center Experience and Literature Review of Management Strategies forInfectious diseases in clinical practice (Baltimore, Md.) · 2020Article
- Intensity of Therapy for Malignancy and Risk for Recurrent and Complicated Clostridium difficile Infection in Children.Journal of pediatric hematology/oncology · 2019Article
- Clostridioides difficile Infection in the Stem Cell Transplant and Hematologic Malignancy Population.Infectious disease clinics of North America · 2019Review
- Incidence Rates and Risk Factors ofOpen forum infectious diseases · 2019Article
- Article
- Epidemiology and outcomes of Clostridium difficile infection in allogeneic hematopoietic cell and lung transplant recipients.Transplant infectious disease : an official journal of the Transplantation Society · 2018Article
- Rethinking Antimicrobial Prophylaxis in the Transplant Patient in the World of Emerging Resistant Organisms-Where Are We Today?Current hematologic malignancy reports · 2018Review
- Risk forTransplantation direct · 2017Article
- Rates of Microbiologically Diagnosed Infection and Pathogen Detection in Hematopoietic Stem Cell Transplant Patients.Military medicine · 2016Article
- Clostridium difficile Infections amongst Patients with Haematological Malignancies: A Data Linkage Study.PloS one · 2016Article
- Transmission of Clostridium difficile During Hospitalization for Allogeneic Stem Cell Transplant.Infection control and hospital epidemiology · 2016Article
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) recipients are at high risk for developing Clostridium difficile infection (CDI). We studied the incidence, risk factors, NAP1/027 prevalence, and clinical outcomes, including acute lower gastrointestinal graft-versus-host disease (GI GVHD), associated with early CDI in this population. A retrospective review was conducted of patients who underwent allogeneic HSCT at Memorial Sloan Kettering Cancer Center from January 1, 2005 to September 30, 2010. Early CDI was defined as infection occurring from day -10 to day +40 from stem cell infusion. Among 793 patients who received allogeneic HSCTs, early CDI occurred in 11.9%; 56% cases were between day -5 and day +5. Overall incidence was 25.2 cases/10,000 at-risk days. There was a high prevalence of NAP1/027 strains during peak incidence (61% in 2008). NAP1/027 was the most common strain in both adult and pediatric cases (24% and 23%, respectively). CDI was clinically mild, including those due to NAP1/027. Metronidazole was the primary treatment for 91 of 94 patients, 7 of 8 cases refractory to metronidazole had no response to vancomycin, and none was due to NAP1/027. Relapse of CDI was common (31%). The cumulative incidence of GI GVHD in patients with and without early CDI was 6.8% and 8%, respectively (P = .5). Most cases of CDI occurred during conditioning or immediately after transplant. Despite high prevalence of NAP1/027, we found only mild disease. Most patients were treated successfully with metronidazole, irrespective of NAP1/027 status. There was no significant association between early CDI and subsequent development of GI GVHD. This study demonstrates the high incidence of CDI early after allogeneic HSCT with wide diversity among infecting strains. Despite the high prevalence of NAP1/027, the disease is mild but relapses are common. No association was found between CDI and subsequent development of GI GVHD.
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