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Case Reports
. 2023 Jul;24(4):182-186.
doi: 10.1177/17571774231165410. Epub 2023 Mar 21.

Late poor outcomes of Clostridioides difficile infections in oncological patients: A multicentre cohort study

Esther Calbo  1   2   3 , Sergi Hernández  3 , Nieves Sopena  4 , Laia Castellá  5 , Joaquín Lopez-Contreras  6 , Jordi Cuquet  7 , Maria López-Sánchez  1 , Rafel Pérez  8 , Carlota Gudiol  9 , Ana Coloma  10 , Mariló Marimón  11 , Joan Espinach  12 , Marta Andres  13 , Purificación Martos  14 , Gonçalo Carvalho Rodrigues  3 , Enric Limón  3   15   16
Affiliations
Case Reports

Late poor outcomes of Clostridioides difficile infections in oncological patients: A multicentre cohort study

Esther Calbo et al. J Infect Prev. 2023 Jul.

Abstract

Background: Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce.

Aim/objective: The aim of the present study was to compare outcomes between oncological patients and the general population with Clostridioides difficile infection (CDI) after 90 days of follow-up.

Methods: A multicenter prospective cohort study was conducted in 28 hospitals participating in the VINCat program. Cases were all consecutive adult patients who met the case definition of CDI. Sociodemographic, clinical, and epidemiological variables and evolution at discharge and after 90 days were recorded for each case.

Findings/results: The mortality rate was higher in oncological patients (OR = 1.70, 95% CI: 1.08-2.67). In addition, oncological patients receiving chemotherapy (CT) presented higher recurrence rates (18.5% vs 9.8%, p = 0.049). Among oncological patients treated with metronidazole, those with active CT showed a higher rate of recurrence (35.3% vs 8.0% p = 0.04).

Discussion: Oncological patients presented a higher risk of poor outcomes after CDI. Their early and late mortality rates were higher than in the general population, and in parallel, those undergoing chemotherapy (especially those receiving metronidazole) had higher rates of recurrence.

Keywords: Clostridioides difficile; Outcome; chemotherapy; metronidazole; oncological patients; vancomycin.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Esther Calbo has accepted grants, speaking engagements, and conference invitations from Astellas, AstraZeneca, Novartis, Pfizer, and MSD. Joaquín Lopez-Contreras has funded by MSD, Pfizer, Actelion, Summit Therapeutics, GSK, Shionogi, Angelini, Marato TV3, and ISCIII to conduct clinical research. Travel support was obtained from Pfizer, MSD, and Guerbet. Education support was obtained from MSD and Pfizer. Advisory board fees from Pfizer, MSD, Hartmann, and Astra-Zeneca. Enric Limón has been a speaker in a symposium organized by MSD. All other authors declare no conflicting interests.

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