2302. Risk factors for Clostridium difficile Infection (CDI) in Intestinal Transplant Recipients (ITR) during the first year post-transplant.
Session: Poster Abstract Session: Transplants: Infection Epidemiology and Outcome in Solid Organ Transplantation
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • CDI Poster IDWEEK 2016.pdf (359.1 kB)
  • Background: C. difficile is the most common cause of healthcare-associated infectious diarrhea. Risk factors for CDI in ITR are not well defined. The aim of our study was to assess specific risk factors for CDI in ITR.

    Methods: We matched 1:3 case-control and included 29 ITR who developed CDI (cases) and 87 ITR who did not develop CDI (controls) during the first year post-transplant. Wilcoxon rank-sum and Fisher’s exact tests were used to compare variables. Univariate and multivariable conditional logistic regressions analysis were performed to identify risk factors.

    Results: Table 1 describes characteristics of the two groups.

    Table 1.

    The median time-to-CDI after transplantation was 163 days (16 – 353 days). Results of univariate analysis are shown in Table 2.

    Table 2.

    The multivariable conditional logistic regression analysis showed that proton pump inhibitors (PPI) administration (OR=0.06; 95% CI: 0.007-0.52; p= 0.01) was associated with lower rates of CDI. Outcomes for cases vs. controls: episodes of rejection 24.14% vs. 20.69% (p= 0.7), graft loss 0% vs. 2.3% (p= 0.99) and survival rate 1 year post-transplant 79.3% (59.6-90.1%) vs. 87.2% (78.1- 92.7%) (p= 0.38).

    Conclusion: We found PPI administration to be protective for CDI in ITR. Risks factors for CDI in ITR might be different from other populations, based on anatomical differences and medication administered both of which may impact intestinal microbiota.

    Luis Guzman Vinasco, MD1, Andre C. Kalil, MD, MPH, FIDSA2, Fang Qui, PhD3, David Mercer, MD, PhD4, Alan Langnas, DO4 and Diana F. Florescu, MD2, (1)Infectious Diseases, University Nebraska Medical Center UNMC, Omaha, NE, (2)Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, (3)College of Public Health, University of Nebraska Medical Center, Omaha, NE, (4)Transplant Surgery, University of Nebraska Medical Center, Omaha, NE

    Disclosures:

    L. Guzman Vinasco, None

    A. C. Kalil, None

    F. Qui, None

    D. Mercer, None

    A. Langnas, None

    D. F. Florescu, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.