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171 Outcomes of Clostridium difficile Infection in Intra-abdominal solid organ transplant Recipients

Saturday, April 2, 2011
Trinity Ballroom (Hilton Anatole)
Jacob Enser , School of Medicine and Public Health, University of Wisconsin, Madison, WI
Trevor McKown , School of Medicine and Public Health, University of Wisconsin, Madison, WI
Jennifer Hsu , University of Wisconsin Madison, Madison, WI
Valerie Knasinski , University of Wisconsin Madison, Madison, WI
John Pirsch, MD , School of Medicine and Public Health, University of Wisconsin, Madison, WI
Nasia Safdar , School of Medicine and Public Health, University of Wisconsin, Madison, WI
Background: Among recipients of intra-abdominal, solid organ transplants, diarrhea is a common problem and Clostridium difficile is an increasingly recognized pathogen.  Knowledge of outcomes of C. difficile Infection (CDI) in SOT recipients is limited

Objective: To evaluate outcomes of CDI among intra-abdominal, solid organ transplant recipients.

Methods: We undertook a retrospective cohort study of all recipients of kidney and liver transplants diagnosed with CDI at a single center over a 13-year period.  Data pertaining to all episodes of CDI were collected. Multivariate analysis using logistic regression was performed to determine independent predictors of hospital mortality.

Results: 106 kidney and 63 liver transplant recipients had 215 episodes of CDI. 80% of patients had a single episode  and 16% had two episodes. There were 106 (62%) men and 64 (38%) women with a mean age of 55 (SD 10.93, range 25-75). Among all episodes, 48 patients (22%) had fever, 33 (15%) were hypothermic, 67 (31%) were hypotensive, and 37 (17%) were tachycardic. 11 (5%) were in the ICU. 14 (6.5%) were on vasopressors. Overall, 162 episodes (75%) were cured with 62 episodes (75%) in liver recipients and 100 episodes (76%) in kidney recipients. In 103 episodes (48%), patients were cured within 14 days. 13 patients (8%) died during hospitalization and 49 patients died within one year. No deaths were attributed to CDI. In multivariable analysis using death during hospitalization as the outcome, female gender was

Conclusions: CDI in solid organ transplant recipients is associated with a 75% cure rate. Risk factors for death during hospitalization include male gender and hemodialysis.