Clostridium difficile infection in dialysis patients

Ankita Tirath, Sandra Tadros, Samuel L. Coffin, Kristina W. Kintziger, Jennifer L Waller, Stephanie Baer, Rhonda Elizabeth Colombo, Lu Yu Huber, Mufaddal F. Kheda, Norris Stanley Nahman

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Clostridium difficile infection (CDI) is the most common cause of nosocomial diarrhea. Patients with end-stage renal disease (ESRD) may be at increased risk for CDI. Patients with ESRD with CDI have increased mortality, longer length of stay, and higher costs. The present studies extend these observations and address associated comorbidities, incidence of recurrence, and risk factors for mortality. We queried the United States Renal Data System (USRDS) for patients with ESRD diagnosed with CDI, and assessed for the incidence of infection, comorbidities, and mortality. The records of 419,875 incident dialysis patients from 2005 to 2008 were reviewed. 4.25% had a diagnosis of a first CDI. In the majority of patients with CDI positive, a hospitalization or ICU stay was documented within 90 days prior to the diagnosis of CDI. The greatest adjusted relative risk (aRR) of CDI was present in patients with HIV (aRR 2.68), age ≥65 years (aRR 1.76), and bacteremia (aRR 1.74). The adjusted HR (aHR) for death was 1.80 in patients with CDI. The comorbidities demonstrating the greatest risk for death in dialysis patients with CDI included age ≥65 years and cirrhosis (aHR 2.28 and 1.76, respectively). Recurrent CDI occurred in 23.6%, was more common in Caucasians, and in those who were older. CDI is a common occurrence in patients with ESRD, with elderly patients, patients with HIV positive, and bacteremic patients at highest risk for infection. Patients with CDI had nearly a twofold increased risk of death.

Original languageEnglish (US)
Pages (from-to)353-357
Number of pages5
JournalJournal of Investigative Medicine
Volume65
Issue number2
DOIs
StatePublished - Feb 1 2017

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Clostridium Infections
Clostridium
Dialysis
Clostridium difficile
Chronic Kidney Failure
Comorbidity
Mortality
HIV
Intensive care units
Incidence
Bacteremia
Infection
Information Systems

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Clostridium difficile infection in dialysis patients. / Tirath, Ankita; Tadros, Sandra; Coffin, Samuel L.; Kintziger, Kristina W.; Waller, Jennifer L; Baer, Stephanie; Colombo, Rhonda Elizabeth; Huber, Lu Yu; Kheda, Mufaddal F.; Nahman, Norris Stanley.

In: Journal of Investigative Medicine, Vol. 65, No. 2, 01.02.2017, p. 353-357.

Research output: Contribution to journalArticle

Tirath, A, Tadros, S, Coffin, SL, Kintziger, KW, Waller, JL, Baer, S, Colombo, RE, Huber, LY, Kheda, MF & Nahman, NS 2017, 'Clostridium difficile infection in dialysis patients', Journal of Investigative Medicine, vol. 65, no. 2, pp. 353-357. https://doi.org/10.1136/jim-2016-000183
Tirath, Ankita ; Tadros, Sandra ; Coffin, Samuel L. ; Kintziger, Kristina W. ; Waller, Jennifer L ; Baer, Stephanie ; Colombo, Rhonda Elizabeth ; Huber, Lu Yu ; Kheda, Mufaddal F. ; Nahman, Norris Stanley. / Clostridium difficile infection in dialysis patients. In: Journal of Investigative Medicine. 2017 ; Vol. 65, No. 2. pp. 353-357.
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