Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-12-01T03:28:12.011Z Has data issue: false hasContentIssue false

Severity of Clostridium difficile–Associated Disease (CDAD) in Allogeneic Stem Cell Transplant Recipients: Evaluation of a CDAD Severity Grading System

Published online by Cambridge University Press:  02 January 2015

Erik R. Dubberke*
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis
Justin Sadhu
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis
Robert Gatti
Affiliation:
University of Missouri—Kansas City School of Dentistry, Kansas City, Missouri
Kimberly A. Reske
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis
John F. DiPersio
Affiliation:
Division of Oncology, Washington University School of Medicine, St. Louis
Steven M. Devine
Affiliation:
Division of Oncology, Washington University School of Medicine, St. Louis
Victoria J. Fraser
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis
*
Division of Infectious Diseases, Washington University School of Medicine, Campus Box 8051, 660 S. Euclid Avenue, St. Louis, MO 63110 ([email protected])

Abstract

The purpose of this study was to develop and test a Clostridium difficile-associated disease (CDAD) grading system based on presenting symptoms in allogeneic stem cell transplant recipients. Patients with severe CDAD had significantly shorter median survival times and more adverse outcomes than patients with mild or moderate CDAD.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Johnson, S, Gerding, DN. Clostridium difficile-associated diarrhea. Clin Infect Dis 1998;26:10271034.Google Scholar
2.Altclas, J, Requejo, A, Jaimovich, G, Milovic, V, Feldman, L. Clostridium difficile infection in patients with neutropenia. Clin Infect Dis 2002;34:723.CrossRefGoogle ScholarPubMed
3.Avery, R, Pohlman, B, Adal, K, et al. High prevalence of diarrhea but infrequency of documented Clostridium difficile in autologous peripheral blood progenitor cell transplant recipients. Bone Marrow Transplant 2000;25:6769.CrossRefGoogle ScholarPubMed
4.Bilgrami, S, Feingold, JM, Dorsky, D, et al. Incidence and outcome of Clostridium difficile infection following autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 1999;23:10391042.CrossRefGoogle ScholarPubMed
5.Blot, E, Escande, MC, Besson, D, et al. Outbreak of Clostridium difficile-related diarrhoea in an adult oncology unit: risk factors and microbiological characteristics. J Hosp Infect 2003;53:187192.Google Scholar
6.Chakrabarti, S, Lees, A, Jones, SG, Milligan, DW. Clostridium difficile infection in allogeneic stem cell transplant recipients is associated with severe graft-versus-host disease and non-relapse mortality. Bone Marrow Transplant 2000;26:871876.Google Scholar
7.Gorschluter, M, Glasmacher, A, Hahn, C, et al. Clostridium difficile infection in patients with neutropenia. Clin Infect Dis 2001;33:786791.CrossRefGoogle ScholarPubMed
8.Kavan, P, Sochor, M, Nyc, O, et al. Pseudomembraneous Clostridium after autologous bone marrow transplantation. Bone Marrow Transplant 1998;21:521523.Google Scholar
9.Tomblyn, M, Gordon, L, Singhai, S, et al. Rarity of toxigenic Clostridium difficile infections after hematopoietic stem cell transplantation: implications for symptomatic management of diarrhea. Bone Marrow Transplant 2002;30:517519.Google Scholar
10.van Kraaij, MG, Dekker, AW, Verdonck, LF, et al. Infectious gastro-enteritis: an uncommon cause of diarrhoea in adult allogeneic and autologous stem cell transplant recipients. Bone Marrow Transplant 2000;26:299303.CrossRefGoogle ScholarPubMed
11.Ascioglu, S, Rex, JH, de Pauw, B, et al. Denning opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. Clin Infect Dis 2002;34:714.Google Scholar
12.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.Google Scholar
13.National Cancer Institute. Common toxicity criteria v2.0 and common terminology criteria for adverse events v3.0. Available at: http://ctep.cancer.gov/reporting/ctc.html. Accessed September 2003.Google Scholar
14.Kyne, L, Merry, C, O'Connell, B, et al. Factors associated with prolonged symptoms and severe disease due to Clostridium difficile. Age Ageing 1999;28:107113.Google Scholar
15.Rubin, MS, Bodenstein, LE, Kent, KC. Severe Clostridium difficile colitis. Dis Colon Rectum 1995;38:350354.Google Scholar
16.Siemann, M, Koch-Dorfler, M, Rabenhorst, G. Clostridium difficile-associated diseases: the clinical courses of 18 fatal cases. Intensive Care Med 2000;26:416421.CrossRefGoogle ScholarPubMed
17.Dobson, G, Hickey, C, Trinder, J. Clostridium difficile colitis causing toxic megacolon, severe sepsis and multiple organ dysfunction syndrome. Intensive Care Med 2003;29:1030.Google Scholar
18.Jacobs, A, Barnard, K, Fishel, R, Gradon, JD. Extracolonic manifestations of Clostridium difficile infections: presentation of 2 cases and review of the literature. Medicine (Baltimore) 2001;80:88101.Google Scholar
19.Lowenkron, SE, Waxner, J, Khullar, P, et al. Clostridium difficile infection as a cause of severe sepsis. Intensive Care Med 1996;22:990994.Google Scholar
20.Chatila, W, Manthous, CA. Clostridium difficile causing sepsis and an acute abdomen in critically ill patients. Crit Care Med 1995;23:11461150.Google Scholar