Clostridium difficile infection in solid organ transplant recipients.
OBJECTIVE
To provide a general understanding of Clostridium difficile infection with a focus on recent publications that evaluate the disease in solid organ transplant recipients.


RESULTS
The incidence of C. difficile infection is increasing worldwide. Epidemics due to a hypervirulent C. difficile strain are associated with an escalating severity of disease. New evidence further supports basing initial treatment choice on disease severity.


CONCLUSIONS
C. difficile is a significant pathogen in solid organ transplant recipients. Multiple risk factors are found in this population that may result in more severe disease. A high index of suspicion is necessary for the early diagnosis and treatment of C. difficile infection in transplant recipients. Metronidazole and vancomycin show equivalent efficacy in the treatment for mild-to-moderate disease, but vancomycin has demonstrated superiority in the treatment of severe disease. Surgical intervention is also an important consideration in the treatment of solid organ transplant recipients with severe colitis. Rigorous infection control practices are essential for preventing the spread of C. difficile within the hospital environment.
Riddle
David J
DJ
Division of Infectious Diseases, Department of Medicine, Washington University in St Louis, St Louis, Missouri 63110, USA.
Dubberke
Erik R
ER
D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000472:pathogenicity*; D013505:Digestive System Surgical Procedures; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D017053:Infection Control; D008795:Metronidazole / Q000627:therapeutic use; D016377:Organ Transplantation / Q000009:adverse effects*; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use; D014774:Virulence
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D014640:Vancomycin