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. 2024 Apr;52(2):649-660.
doi: 10.1007/s15010-024-02193-1. Epub 2024 Feb 26.

Clostridioides difficile recurrence in individuals with and without cancer: a Swedish population-based cohort study

Peace Mpakaniye  1   2 , Annelies Boven  1   2   3 , Steven Callens  4 , Lars Engstrand  1 , Erika Vlieghe  2   5 , Nele Brusselaers  6   7   8
Affiliations

Clostridioides difficile recurrence in individuals with and without cancer: a Swedish population-based cohort study

Peace Mpakaniye et al. Infection. 2024 Apr.

Abstract

Purpose: Patients with cancer are vulnerable to Clostridioides difficile infection (CDI) due to their disease, treatment and regular hospital contact, yet if CDI-recurrence is more common remains unclear, and differences among cancer types remain unexplored.

Methods: This Swedish nationwide population-based cohort included all 43,150 individuals with recorded CDI (2006-2019) to assess CDI-recurrence in individuals with and without cancer, with binary multivariable logistic regression, stratified by anatomical location, and survival status.

Results: Compared to those without cancer (N = 29,543), ongoing cancer (diagnosis < 12 months; N = 3,882) was associated with reduced recurrence (OR = 0.81, 95% CI 0.73-0.89), while there was no association with cancer history (diagnosis ≥ 12 months; N = 9,725). There was an increased 8-week all-cause mortality (Ongoing cancer: OR = 1.58, 95% CI 1.43-1.74; Cancer history: OR = 1.45, 95% CI 1.36-1.55) compared to those without cancer. Among CDI-survivors, those with ongoing cancer presented with a decreased odds of recurrence (OR = 0.84, 95% CI 0.76-0.94), compared to those without cancer history, with no association for those with cancer history (OR = 1.04, 95% CI 0.97-1.1). Large variations were seen across cancer types, with the highest observed proportion of recurrence in oral and mesothelial cancer, and the lowest for esophageal cancer, although no statistically significant OR were found.

Conclusion: The population-based study indicates that individuals with cancer may have fewerrecurrences than expected, yet variations by cancer type were large, and mortality was high.

Keywords: Clostridioides difficile; Cancer; Epidemiology; Real World Evidence; Recurrence; Risk factors.

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Conflict of interest statement

There are no conflicts of interest declared by the authors.

Figures

Fig. 1
Fig. 1
Flow chart of all individuals with a recorded Clostridioides difficile infection (CDI) diagnosis in Sweden between 2006 and 2019
Fig. 2
Fig. 2
Observed proportion of recurrence for the different cancer types in individuals with Clostridioides difficile infection (CDI) and ongoing cancer (diagnosed < 1 year)
Fig. 3
Fig. 3
Cause specific cumulative incidence for all with or without (ongoing cancer)
See this image and copyright information in PMC

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References

    1. Seekatz AM, Safdar N, Khanna S. The role of the gut microbiome in colonization resistance and recurrent Clostridioides difficile infection. Ther Adv Gastroenterol. 2022;15:17562848221134396. doi: 10.1177/17562848221134396. - DOI - PMC - PubMed
    1. Sehgal K, Khanna S. Gut microbiome and Clostridioides difficile infection: a closer look at the microscopic interface. Therap Adv Gastroenterol. 2021;14:1756284821994736. doi: 10.1177/1756284821994736. - DOI - PMC - PubMed
    1. Cold F, Svensson CK, Petersen AM, Hansen LH, Helms M. Long-term safety following faecal microbiota transplantation as a treatment for recurrent Clostridioides difficile infection compared with patients treated with a fixed bacterial mixture: results from a retrospective cohort study. Cells. 2022 doi: 10.3390/cells11030435. - DOI - PMC - PubMed
    1. Soveral LF, Korczaguin GG, Schmidt PS, Nunes IS, Fernandes C, Zárate-Bladés CR. Immunological mechanisms of fecal microbiota transplantation in recurrent Clostridioides difficile infection. World J Gastroenterol. 2022;28:4762–4772. doi: 10.3748/wjg.v28.i33.4762. - DOI - PMC - PubMed
    1. Khan I, Bai Y, Zha L, Ullah N, Ullah H, Shah SRH, et al. Mechanism of the gut microbiota colonization resistance and enteric pathogen infection. Front Cell Infect Microbiol. 2021 doi: 10.3389/fcimb.2021.716299. - DOI - PMC - PubMed