title: Relative incidences and outcomes of Clostridium difficile infection following transplantation of unrelated cord blood, unrelated bone marrow, and related peripheral blood in adult patients: a single institute study.
abstract: BACKGROUND
  Clostridium difficile is a major cause of nosocomial diarrhea. The incidence and prognosis of C. difficile-associated diarrhea (CDAD) has not yet been assessed in adult patients after unrelated cord blood transplantation (uCBT).
  
  
  METHODS
  The medical records of 135 adult unrelated cord blood transplant recipients were reviewed retrospectively to investigate the clinical features of CDAD after uCBT. These data were compared to medical records of 39 unrelated bone marrow transplant recipients and 27 related peripheral blood stem cell transplant recipients as controls.
  
  
  RESULTS
  A total of 17 recipients developed CDAD, with onset occurring at a median of 22 days (range, 0-56 days) after transplantation. Among the unrelated cord blood transplant recipients, 11 (9%) developed CDAD. These results were comparable with those of CDAD after unrelated bone marrow transplantation (uBMT) (2/39, 6%) and related peripheral blood stem cell transplantation (rPBSCT) (4/27, 16%) (P=0.37). Fifteen of the infected recipients were successfully treated with oral metronidazole, vancomycin, or cessation of antibiotics. The remaining 2 recipients who developed CDAD after uCBT died of other causes. The development of CDAD did not negatively affect overall survival after uCBT.
  
  
  CONCLUSIONS
  These data indicate that the incidence and prognosis of CDAD after uCBT are comparable with those after uBMT and rPBSCT.
authors.affiliation: Department of Hematology, Toranomon Hospital, Tokyo, Japan; Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hosokawa
authors.forename: A
authors.initials: A
authors.lastname: Takami
authors.forename: M
authors.initials: M
authors.lastname: Tsuji
authors.forename: H
authors.initials: H
authors.lastname: Araoka
authors.forename: K
authors.initials: K
authors.lastname: Ishiwata
authors.forename: S
authors.initials: S
authors.lastname: Takagi
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Asano-Mori
authors.forename: N
authors.initials: N
authors.lastname: Matsuno
authors.forename: N
authors.initials: N
authors.lastname: Uchida
authors.forename: K
authors.initials: K
authors.lastname: Masuoka
authors.forename: A
authors.initials: A
authors.lastname: Wake
authors.forename: S
authors.initials: S
authors.lastname: Makino
authors.forename: A
authors.initials: A
authors.lastname: Yoneyama
authors.forename: S
authors.initials: S
authors.lastname: Nakao
authors.forename: S
authors.initials: S
authors.lastname: Taniguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001782:Blood Donors; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000209:etiology*; D036101:Cord Blood Stem Cell Transplantation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome; D061349:Unrelated Donors; D055815:Young Adult
keywords: Clostridium difficile; cord blood transplantation; diarrhea