ArticleTransplant infectious disease : an official journal of the Transplantation Society2019
Risk factors for Clostridioides (Clostridium) difficile infection following solid organ transplantation in children.
Article in Transplant infectious disease : an official journal of the Transplantation Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- Post-transplant diarrhea in pediatric kidney transplant recipients.Pediatric nephrology (Berlin, Germany) · 2025Review
- Review
- Review
- Clostridioides difficile Infection in Children: Recent Updates on Epidemiology, Diagnosis, Therapy.Pediatrics · 2023Review
- Fecal Microbiota Transplantation for Clostridioides difficile Infection in Immunocompromised Pediatric Patients.Journal of pediatric gastroenterology and nutrition · 2023Article
- Clostridioides difficile Infection in Hospitalized Pediatric Patients: Comparisons of Epidemiology, Testing, and Treatment from 2013 to 2019.The Journal of pediatrics · 2023Article
- Epidemiology, Diagnosis, and Treatment of Clostridioides difficile Infection in Immunocompromised Children.Journal of the Pediatric Infectious Diseases Society · 2021Article
- Safe and successful fecal microbiota transplantation for recurrentIntestinal Failure (New York, N.Y.)Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundClostridioides (Clostridium) difficile infection (CDI) in pediatric solid organ transplant (SOT) recipients is a growing problem, though CDI risk factors in this population are poorly understood. Our objective was to characterize CDI risk factors in pediatric SOT recipients.
methodsThis retrospective case-control study, performed at a single freestanding academic children's hospital, included all SOT recipients age 1-22 years who were tested for C. difficile by toxin B gene PCR between August 2009 and August 2017. CDI risk factors were assessed by comparing PCR-positive and PCR-negative cases by generalized linear mixed models.
resultsBetween August 2009 and August 2017, 409 SOTs were performed of which 138 (33.7%), 134 (32.8%), 131 (32.0%), and 6 (1.5%) were kidney, liver, heart, and small intestine transplants, respectively. Of 205 SOT recipients were tested for CDI, with 723 C. difficile PCR tests performed among these patients. 68/205 (33%) patients developed CDI at least once during the study period. Median (interquartile range) time to diagnosis of first CDI following SOT was 8.9 (1.2, 19.6) months. CDI was independently associated with calcineurin inhibitor use at time of C. difficile testing (odds ratio [OR] 2.38, 95% confidence interval [CI] 1.08, 5.24, P = 0.03) and systemic antibiotic exposure within 30 days of C. difficile testing (OR 1.74, 95% CI 1.08, 2.79, P = 0.02).
conclusionsCDI is a common, relatively late post-transplant complication and independently associated with calcineurin inhibitor and systemic antibiotic exposure. The potential impact of specific immunosuppressive drug and antibiotic selection on CDI risk reduction requires further investigation.
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