Department of Medicine, Section of Infectious Diseases & Global Health, University of Chicago, Chicago, Illinois.
Department of Medicine, Division of Infectious Diseases, School of Medicine, Washington University, St. Louis, Missouri.
Clin Transplant. 2019 Sep;33(9):e13564. doi: 10.1111/ctr.13564. Epub 2019 Jun 20.
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.
这些来自美国移植传染病学会实践社区的更新指南涉及预防和管理实体器官移植 (SOT) 受者中的艰难梭菌感染。艰难梭菌感染 (CDI) 是最常见的医院获得性感染之一。在 SOT 受者中,CDI 的发生率因移植类型和器官数量而异。虽然对已发表文献的荟萃分析发现普通外科人群术后 CDI 的患病率约为 0.51%,但在实体器官移植人群中观察到的 CDI 患病率从胰腺移植人群中的低至 3.2%到接受多器官移植人群中的 12.7%不等。目前尚无评估 SOT 人群中 CDI 管理的随机对照试验。本文回顾并总结了目前已有的文献,这些文献已综合为 SOT 人群中 CDI 管理的更新治疗指南。