Universität zu Köln

Vehreschild, Maria J. G. T., Weitershagen, David, Biehl, Lena M., Tacke, Daniela, Waldschmidt, Dirk, Toex, Ulrich, Wisplinghoff, Hilmar, Bergwelt-Baildon, Michael V., Cornely, Oliver A. and Vehreschild, Joerg J. (2014). Clostridium Difficile Infection in Patients with Acute Myelogenous Leukemia and in Patients Undergoing Allogeneic Stem Cell Transplantation: Epidemiology and Risk Factor Analysis. Biol. Blood Marrow Transplant., 20 (6). S. 823 - 829. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1523-6536

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Abstract

Patients receiving treatment for acute myelogenous leukemia (AML) and recipients of allogeneic stem cell transplantation (aSCT) are at high risk of contracting Clostridium difficile infection (CDI), the most frequently observed nosocomial diarrhea and enterocolitis. Data were retrieved from the prospective Cologne Cohort of Neutropenic Patients. Patients hospitalized for aSCT as well as patients receiving treatment for AML were included in the analysis. Risk factor analysis for the occurrence of CDI was performed by backward-stepwise logistic regression (P < .1). During the period from January 2007 to August 2010, 310 hospitalizations of 152 patients with AML and 229 hospitalizations of 223 patients undergoing aSCT were eligible for analysis. Incidence rates for CDI per 10,000 patient days were 17.9 for AML patients and 27.4 for aSCT recipients. Among AML and aSCT patients, median time from initiation of chemotherapy to CDI was 10 days (range, -8 to 101 days) and 17 days (range, 6 to 79), respectively. Logistic regression identified carbapenem exposure to be associated with development of CDI in AML patients (odds ratio [OR], 2.2) and aSCT recipients (OR, 1.4). In both groups, previous exposure to carbapenems was significantly associated with development of CDI. A follow-up study, assessing the effect of an antibiotic stewardship intervention to decrease the administration Of carbapenems in hematological high-risk patients, is warranted. (C) 2014 American Society for Blood and Marrow Transplantation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weitershagen, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Biehl, Lena M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tacke, Daniela UNSPECIFIED UNSPECIFIED UNSPECIFIED Waldschmidt, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Toex, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Wisplinghoff, Hilmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Bergwelt-Baildon, Michael V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Joerg J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-437149
DOI:	10.1016/j.bbmt.2014.02.022
Journal or Publication Title:	Biol. Blood Marrow Transplant.
Volume:	20
Number:	6
Page Range:	S. 823 - 829
Date:	2014
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1523-6536
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DISEASES SOCIETY; BONE-MARROW; 2010 UPDATE; RECIPIENTS; NEUTROPENIA; AMERICA; MICROBIOLOGY; METAANALYSIS; GUIDELINES; MORTALITY Multiple languages Hematology; Immunology; Transplantation Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43714