Treating Clostridium difficile infection in patients presenting with hematological malignancies: Are current guidelines applicable?

Details

Serval ID
serval:BIB_AA7184D0F60D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Treating Clostridium difficile infection in patients presenting with hematological malignancies: Are current guidelines applicable?
Journal
Medecine et maladies infectieuses
Author(s)
Robin C., Héquette-Ruz R., Guery B., Boyle E., Herbaux C., Galperine T.
ISSN
1769-6690 (Electronic)
ISSN-L
0399-077X
Publication state
Published
Issued date
12/2017
Peer-reviewed
Oui
Volume
47
Number
8
Pages
532-539
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Adults with hematological malignancies are at high-risk of Clostridium difficile infection (CDI), but no guidelines for CDI treatment are available in this population. Our primary objective was to evaluate the clinical outcomes in CDI patients with hematological malignancies. Our secondary objectives were to describe CDI severity using the main clinical guidelines and to evaluate the compliance of treatment choice with published guidelines.
Single-center, retrospective, observational case series including every consecutive adult patient with a confirmed diagnosis of CDI admitted in the hematology unit of our teaching hospital. Each CDI episode was classified as moderate, severe, or complicated according to the main clinical guidelines (IDSA 2010, AJG 2013, ESCMID 2014).
Twenty-three episodes of CDI in 19 patients admitted to the hematology unit occurred between June 2012 and October 2013. Clinical cure was achieved for 20 episodes (87%). Ten weeks after diagnosis, global cure was reached for 14 episodes (61%) whereas recurrence occurred in two episodes (10%). The mortality rate reached 37% (7/19) but the attributable mortality rate was 5% (1/19). ESCMID criteria more frequently classified patients in the severe category compared with the two other classifications. Prescription compliance with clinical guidelines was observed in 61% of episodes with IDSA criteria, 43% with AJG, and 9% with ESCMID.
IDSA and AJG assessment may underestimate the potential risk of unfavorable clinical outcome. Further prospective studies on a larger cohort are needed to develop adequate treatment guidelines for CDI in hematology settings.

Keywords
Clinical guidelines, Clostridium difficile infection, Hematology, Hématologie, Infection à Clostridium difficile, Recommandations
Pubmed
Web of science
Create date
19/09/2017 13:51
Last modification date
20/08/2019 15:14
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