Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation

Detalhes bibliográficos
Autor(a) principal: Pilcante,Javier
Data de Publicação: 2015
Outros Autores: Rojas,Patricio, Ernst,Daniel, Sarmiento,Mauricio, Ocqueteau,Mauricio, Bertin,Pablo, García,Maria, Rodriguez,Maria, Jara,Veronica, Ajenjo,Maria, Ramirez,Pablo
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista brasileira de hematologia e hemoterapia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842015000600388
Resumo: ABSTRACT Introduction: Patients submitted to hematopoietic stem cell transplantation have an increased risk of Clostridium difficile infection and multiple risk factors have been identi- fied. Published reports have indicated an incidence from 9% to 30% of transplant patients however to date there is no information about infection in these patients in Chile. Methods: A retrospective analysis was performed of patients who developed C. difficile infection after hematopoietic stem cell transplantations from 2000 to 2013. Statistical analysis used the Statistical Package for the Social Sciences software. Results: Two hundred and fifty patients were studied (mean age: 39 years; range: 17-69), with 147 (59%) receiving allogeneic transplants and 103 (41%) receiving autologous trans- plants. One hundred and ninety-two (77%) patients had diarrhea, with 25 (10%) cases of C. difficile infection being confirmed. Twenty infected patients had undergone allogeneic trans- plants, of which ten had acute lymphoblastic leukemia, three had acute myeloid leukemia and seven had other diseases (myelodysplastic syndrome, chronic myeloid leukemia, severe aplastic anemia). In the autologous transplant group, five patients had C. difficile infection; two had multiple myeloma, one had amyloidosis, one had acute myeloid leukemia and one had germinal carcinoma. The overall incidence of C. difficile infection was 4% within the first week, 6.4% in the first month and 10% in one year, with no difference in overall survival between infected and non-infected groups (72.0% vs. 67.6%, respectively; p-value = 0.56). Patients infected after allogeneic transplants had a slower time to neutrophil engraftment compared to non-infected patients (17.5 vs. 14.9 days, respectively; p-value = 0.008). In the autologous transplant group there was no significant difference in the neutrophil engraftment time between infected and non-infected patients (12.5 days vs. 11.8 days, respectively; p-value = 0.71). In the allogeneic transplant group, the median time to acute graft-versus- host disease was similar between the two groups (p-value = 0.08), as was the incidence of grades 1-4 acute graft-versus-host disease (40% vs. 48%; p-value >0.05). Conclusion: The incidence of C. difficile infection after hematopoietic stem cell transplantation was low, with a significant number of cases occurring shortly after transplantation. Allogeneic transplants had a three-time higher risk of infection compared to autologous transplants, but this was not associated with increased mortality, decreased overall survival or higher risk of acute graft-versus-host disease.
id ABHHTC-1_3229799e698a487d17e2ddb283795b68
oai_identifier_str oai:scielo:S1516-84842015000600388
network_acronym_str ABHHTC-1
network_name_str Revista brasileira de hematologia e hemoterapia (Online)
repository_id_str
spelling Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantationClostridium difficileInfectionHematopoietic stem cell transplantationOutcomesABSTRACT Introduction: Patients submitted to hematopoietic stem cell transplantation have an increased risk of Clostridium difficile infection and multiple risk factors have been identi- fied. Published reports have indicated an incidence from 9% to 30% of transplant patients however to date there is no information about infection in these patients in Chile. Methods: A retrospective analysis was performed of patients who developed C. difficile infection after hematopoietic stem cell transplantations from 2000 to 2013. Statistical analysis used the Statistical Package for the Social Sciences software. Results: Two hundred and fifty patients were studied (mean age: 39 years; range: 17-69), with 147 (59%) receiving allogeneic transplants and 103 (41%) receiving autologous trans- plants. One hundred and ninety-two (77%) patients had diarrhea, with 25 (10%) cases of C. difficile infection being confirmed. Twenty infected patients had undergone allogeneic trans- plants, of which ten had acute lymphoblastic leukemia, three had acute myeloid leukemia and seven had other diseases (myelodysplastic syndrome, chronic myeloid leukemia, severe aplastic anemia). In the autologous transplant group, five patients had C. difficile infection; two had multiple myeloma, one had amyloidosis, one had acute myeloid leukemia and one had germinal carcinoma. The overall incidence of C. difficile infection was 4% within the first week, 6.4% in the first month and 10% in one year, with no difference in overall survival between infected and non-infected groups (72.0% vs. 67.6%, respectively; p-value = 0.56). Patients infected after allogeneic transplants had a slower time to neutrophil engraftment compared to non-infected patients (17.5 vs. 14.9 days, respectively; p-value = 0.008). In the autologous transplant group there was no significant difference in the neutrophil engraftment time between infected and non-infected patients (12.5 days vs. 11.8 days, respectively; p-value = 0.71). In the allogeneic transplant group, the median time to acute graft-versus- host disease was similar between the two groups (p-value = 0.08), as was the incidence of grades 1-4 acute graft-versus-host disease (40% vs. 48%; p-value >0.05). Conclusion: The incidence of C. difficile infection after hematopoietic stem cell transplantation was low, with a significant number of cases occurring shortly after transplantation. Allogeneic transplants had a three-time higher risk of infection compared to autologous transplants, but this was not associated with increased mortality, decreased overall survival or higher risk of acute graft-versus-host disease.Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular2015-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842015000600388Revista Brasileira de Hematologia e Hemoterapia v.37 n.6 2015reponame:Revista brasileira de hematologia e hemoterapia (Online)instname:Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular (ABHHTC)instacron:ABHHTC10.1016/j.bjhh.2015.07.010info:eu-repo/semantics/openAccessPilcante,JavierRojas,PatricioErnst,DanielSarmiento,MauricioOcqueteau,MauricioBertin,PabloGarcía,MariaRodriguez,MariaJara,VeronicaAjenjo,MariaRamirez,Pabloeng2016-01-07T00:00:00Zoai:scielo:S1516-84842015000600388Revistahttp://www.rbhh.org/pt/archivo/https://old.scielo.br/oai/scielo-oai.phpsbhh@terra.com.br||secretaria@rbhh.org1806-08701516-8484opendoar:2016-01-07T00:00Revista brasileira de hematologia e hemoterapia (Online) - Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular (ABHHTC)false
dc.title.none.fl_str_mv Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation
title Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation
spellingShingle Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation
Pilcante,Javier
Clostridium difficile
Infection
Hematopoietic stem cell transplantation
Outcomes
title_short Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation
title_full Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation
title_fullStr Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation
title_full_unstemmed Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation
title_sort Clostridium difficile infection in Chilean patients submitted to hematopoietic stem cell transplantation
author Pilcante,Javier
author_facet Pilcante,Javier
Rojas,Patricio
Ernst,Daniel
Sarmiento,Mauricio
Ocqueteau,Mauricio
Bertin,Pablo
García,Maria
Rodriguez,Maria
Jara,Veronica
Ajenjo,Maria
Ramirez,Pablo
author_role author
author2 Rojas,Patricio
Ernst,Daniel
Sarmiento,Mauricio
Ocqueteau,Mauricio
Bertin,Pablo
García,Maria
Rodriguez,Maria
Jara,Veronica
Ajenjo,Maria
Ramirez,Pablo
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Pilcante,Javier
Rojas,Patricio
Ernst,Daniel
Sarmiento,Mauricio
Ocqueteau,Mauricio
Bertin,Pablo
García,Maria
Rodriguez,Maria
Jara,Veronica
Ajenjo,Maria
Ramirez,Pablo
dc.subject.por.fl_str_mv Clostridium difficile
Infection
Hematopoietic stem cell transplantation
Outcomes
topic Clostridium difficile
Infection
Hematopoietic stem cell transplantation
Outcomes
description ABSTRACT Introduction: Patients submitted to hematopoietic stem cell transplantation have an increased risk of Clostridium difficile infection and multiple risk factors have been identi- fied. Published reports have indicated an incidence from 9% to 30% of transplant patients however to date there is no information about infection in these patients in Chile. Methods: A retrospective analysis was performed of patients who developed C. difficile infection after hematopoietic stem cell transplantations from 2000 to 2013. Statistical analysis used the Statistical Package for the Social Sciences software. Results: Two hundred and fifty patients were studied (mean age: 39 years; range: 17-69), with 147 (59%) receiving allogeneic transplants and 103 (41%) receiving autologous trans- plants. One hundred and ninety-two (77%) patients had diarrhea, with 25 (10%) cases of C. difficile infection being confirmed. Twenty infected patients had undergone allogeneic trans- plants, of which ten had acute lymphoblastic leukemia, three had acute myeloid leukemia and seven had other diseases (myelodysplastic syndrome, chronic myeloid leukemia, severe aplastic anemia). In the autologous transplant group, five patients had C. difficile infection; two had multiple myeloma, one had amyloidosis, one had acute myeloid leukemia and one had germinal carcinoma. The overall incidence of C. difficile infection was 4% within the first week, 6.4% in the first month and 10% in one year, with no difference in overall survival between infected and non-infected groups (72.0% vs. 67.6%, respectively; p-value = 0.56). Patients infected after allogeneic transplants had a slower time to neutrophil engraftment compared to non-infected patients (17.5 vs. 14.9 days, respectively; p-value = 0.008). In the autologous transplant group there was no significant difference in the neutrophil engraftment time between infected and non-infected patients (12.5 days vs. 11.8 days, respectively; p-value = 0.71). In the allogeneic transplant group, the median time to acute graft-versus- host disease was similar between the two groups (p-value = 0.08), as was the incidence of grades 1-4 acute graft-versus-host disease (40% vs. 48%; p-value >0.05). Conclusion: The incidence of C. difficile infection after hematopoietic stem cell transplantation was low, with a significant number of cases occurring shortly after transplantation. Allogeneic transplants had a three-time higher risk of infection compared to autologous transplants, but this was not associated with increased mortality, decreased overall survival or higher risk of acute graft-versus-host disease.
publishDate 2015
dc.date.none.fl_str_mv 2015-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842015000600388
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-84842015000600388
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1016/j.bjhh.2015.07.010
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
publisher.none.fl_str_mv Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular
dc.source.none.fl_str_mv Revista Brasileira de Hematologia e Hemoterapia v.37 n.6 2015
reponame:Revista brasileira de hematologia e hemoterapia (Online)
instname:Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular (ABHHTC)
instacron:ABHHTC
instname_str Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular (ABHHTC)
instacron_str ABHHTC
institution ABHHTC
reponame_str Revista brasileira de hematologia e hemoterapia (Online)
collection Revista brasileira de hematologia e hemoterapia (Online)
repository.name.fl_str_mv Revista brasileira de hematologia e hemoterapia (Online) - Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular (ABHHTC)
repository.mail.fl_str_mv sbhh@terra.com.br||secretaria@rbhh.org
_version_ 1754213112774393856