The epidemiology of Clostridium difficile infection in patients with cancer.
Clostridium difficile infection (CDI) is a significant cause of healthcare-associated diarrhoea, and the emergence of endemic strains resulting in poorer outcomes is recognised worldwide. Patients with cancer are a specific high-risk group for development of infection. Areas covered: In this review, modifiable and non-modifiable risk factors for CDI in adult patients with haematological malignancy or solid tumours are evaluated. In particular, the contribution of antimicrobial exposure, hospitalisation and gastric acid suppression to risk of CDI are discussed. Recent advances in CDI treatment are outlined, namely faecal microbiota transplantation and fidaxomicin therapy for severe/refractory infection in cancer populations. Outcomes of CDI, including mortality are presented, together with the need for valid severity rating tools customised for cancer populations. Expert commentary: Future areas for research include the prognostic value of C. difficile colonisation in cancer patients and the potential impact of dedicated antimicrobial stewardship programs in reducing the burden of CDI in cancer units.
a Department of Infectious Diseases and Infection Prevention , Peter MacCallum Cancer Centre , Melbourne , Australia.
Andrew I T
AI
Hebbard
a Department of Infectious Diseases and Infection Prevention , Peter MacCallum Cancer Centre , Melbourne , Australia.|b Department of Medicine , University of Melbourne , Melbourne , Australia.
Monica A
MA
Slavin
c Microbiology Department , Peter MacCallum Cancer Centre , Melbourne , Australia.
Caroline
C
Reed
a Department of Infectious Diseases and Infection Prevention , Peter MacCallum Cancer Centre , Melbourne , Australia.
Benjamin W
BW
Teh
a Department of Infectious Diseases and Infection Prevention , Peter MacCallum Cancer Centre , Melbourne , Australia.
Karin A
KA
Thursky
a Department of Infectious Diseases and Infection Prevention , Peter MacCallum Cancer Centre , Melbourne , Australia.
Jason A
JA
Trubiano
a Department of Infectious Diseases and Infection Prevention , Peter MacCallum Cancer Centre , Melbourne , Australia.|b Department of Medicine , University of Melbourne , Melbourne , Australia.|d Victorian Healthcare Associated Infection Surveillance System (VICNISS) , Doherty Institute , Melbourne , Australia.
Leon J
LJ
Worth
D000328:Adult; D000617:Aminoglycosides / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001431:Bacteriological Techniques; D016360:Clostridioides difficile / Q000187:drug effects / Q000302:isolation & purification*; D004363:Drug Utilization / Q000592:standards; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D000069467:Fecal Microbiota Transplantation; D000077732:Fidaxomicin; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D012307:Risk Factors
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D000077732:Fidaxomicin
Clostridium difficile infection; cancer; epidemiology; outcomes; risks; treatment