Management of Clostridioides (formerly Clostridium) difficile infection (CDI) in solid organ transplant recipients: Guidelines from the American Society of Transplantation Community of Practice

Clin Transplant. 2019 Sep;33(9):e13564. doi: 10.1111/ctr.13564. Epub 2019 Jun 20.

Abstract

These updated guidelines from the American Society of Transplantation Infectious Diseases Community of Practice address the prevention and management of Clostridium difficile infection in solid organ transplant (SOT) recipients. Clostridioides (formerly Clostridium) difficile infection (CDI) is among the most common hospital acquired infections. In SOT recipients, the incidence of CDI varies by type and number or organs transplanted. While a meta-analysis of published literature found the prevalence of postoperative CDI in the general surgical population to be approximately 0.51%, the prevalence of CDI that is seen in the solid organ transplant population ranges from a low of 3.2% in the pancreatic transplant population to 12.7% in those receiving multiple organ transplants. There are no randomized, controlled trials evaluating the management of CDI in the SOT population. Herein is a review and summary of the currently available literature that has been synthesized into updated treatment guidelines for the management of CDI in the SOT population.

Keywords: Clostridium difficile; antibiotic-associated diarrhea; nosocomial infection; pseudomembranous colitis; solid organ transplant.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Clostridioides difficile / isolation & purification*
  • Clostridium Infections / diagnosis*
  • Clostridium Infections / drug therapy*
  • Clostridium Infections / etiology
  • Disease Management
  • Humans
  • Organ Transplantation / adverse effects*
  • Practice Guidelines as Topic / standards*
  • Societies, Medical
  • Transplant Recipients

Substances

  • Anti-Bacterial Agents