Baseline Patient Characteristics of HCT Patients With C Difficile Infectiona
| Characteristic Demographics and Clinical Characteristics . | Allogeneic HCT (n = 248) . | Autologous HCT (n = 168) . | All (n = 416) . |
|---|---|---|---|
| Age at HCT in years, median (range) | 53 (20–80) | 59 (19–74) | 56 (19–80) |
| Sex | |||
| Female | 107 (43%) | 71 (42%) | 178 (43%) |
| Male | 141 (57%) | 97 (58%) | 238 (57%) |
| Underlying malignancy | |||
| Acute leukemia | 176 (71%) | 1 (0.6%) | 177 (43%) |
| Chronic leukemia | 10 (4%) | 0 (0%) | 10 (2%) |
| Hodgkin lymphoma | 2 (0.8%) | 11 (7%) | 13 (3%) |
| Non-Hodgkin lymphoma | 4 (2%) | 50 (30%) | 54 (13%) |
| Myelodysplastic syndrome | 47 (19%) | 0 (0%) | 47 (11%) |
| Multiple myeloma | 1 (0.4%) | 93 (55%) | 94 (23%) |
| Other | 8 (3%) | 13 (8%) | 21 (5%) |
| Stem cell source | |||
| Peripheral blood | 199 (80.2%) | 168 (100%) | 367 (88.2%) |
| Cord | 35 (14.1%) | 0 (0%) | 35 (8.4%) |
| Bone marrow | 13 (5.2%) | 0 (0%) | 13 (3.1%) |
| Bone marrow, peripheral blood | 1 (0.4%) | 0 (0%) | 1 (0.2%) |
| Location of HCT | |||
| Inpatient | 216 (87%) | 109 (65%) | 325 (78%) |
| Outpatient | 32 (13%) | 59 (35%) | 91 (22%) |
| Donor relationship | |||
| Autologous | 0 (0%) | 168 (100%) | 168 (40%) |
| Matched | 176 (71%) | – | 176 (42%) |
| Haploidentical | 16 (6.5%) | – | 16 (4%) |
| Mismatched | 21 (8.5%) | – | 21 (5%) |
| Cord blood | 35 (14%) | – | 35 (8%) |
| Presence of acute GVHDb | 34 (14%) | – | 34 (8%) |
| Acute GVHD gradec | |||
| 1 | 1 (3%) | – | 1 (3%) |
| 2 | 27 (79%) | – | 27 (79%) |
| 3 | 5 (15%) | – | 5 (15%) |
| 4 | 1 (3%) | – | 1 (3%) |
| Prior history of CDId | 19 (8%) | 17 (10%) | 36 (9%) |
| Exposure to proton pump inhibitorse | 129 (52%) | 93 (55%) | 222 (54%) |
| Positive CMV serostatus at transplant | 148 (61%) | 102 (61%) | 250 (61%) |
| Diagnosis of CMV infectionf | 13 (5%) | 1 (1%) | 14 (3%) |
| Engraftment at CDI diagnosisg | 65 (26%) | 41 (24%) | 106 (25%) |
| Concomitant infection at CDI diagnosis | 64 (26%) | 18 (11%) | 82 (20%) |
| Exposure to antibiotics with anaerobic coverage | 37 (15%) | 27 (16%) | 64 (15%) |
| Initial CDI episode characteristics | |||
| Days from transplant to CDI median (range) | 3.5 (−7 to 97) | 6 (−5 to 93) | 5 (−7 to 97) |
| Feverh | 35 (15%) | 52 (33%) | 87 (22%) |
| WBC count cell/microliter median (range)i | 1495 (0–19,700) | 1060 (0–15,270) | 1245 (0–19,700) |
| Neutropeniaj | 84 (34%) | 77 (46%) | 161 (39%) |
| Treatment regimens used for index CDI | |||
| Oral vancomycin | 79 (31.9%) | 48 (28.6%) | 127 (30.5%) |
| Oral metronidazole | 61 (24.6%) | 45 (26.8%) | 106 (25.5%) |
| Oral and IV metronidazole | 25 (10%) | 28 (16.7%) | 53 (12.8%) |
| IV metronidazole | 7 (2.8%) | 3 (1.8%) | 10 (2.4%) |
| Oral vancomycin + metronidazole (IV or oral) | 75 (30%) | 44 (26.1%) | 119 (28.6) |
| Fidaxomicin | 1 (0.4%) | 0 (0) | 1 (0.2%) |
| Duration of treatment regimen for index CDI, median days (range) | 14 (4–34) | 14 (6–38) | 14 (4–38) |
| Characteristic Demographics and Clinical Characteristics . | Allogeneic HCT (n = 248) . | Autologous HCT (n = 168) . | All (n = 416) . |
|---|---|---|---|
| Age at HCT in years, median (range) | 53 (20–80) | 59 (19–74) | 56 (19–80) |
| Sex | |||
| Female | 107 (43%) | 71 (42%) | 178 (43%) |
| Male | 141 (57%) | 97 (58%) | 238 (57%) |
| Underlying malignancy | |||
| Acute leukemia | 176 (71%) | 1 (0.6%) | 177 (43%) |
| Chronic leukemia | 10 (4%) | 0 (0%) | 10 (2%) |
| Hodgkin lymphoma | 2 (0.8%) | 11 (7%) | 13 (3%) |
| Non-Hodgkin lymphoma | 4 (2%) | 50 (30%) | 54 (13%) |
| Myelodysplastic syndrome | 47 (19%) | 0 (0%) | 47 (11%) |
| Multiple myeloma | 1 (0.4%) | 93 (55%) | 94 (23%) |
| Other | 8 (3%) | 13 (8%) | 21 (5%) |
| Stem cell source | |||
| Peripheral blood | 199 (80.2%) | 168 (100%) | 367 (88.2%) |
| Cord | 35 (14.1%) | 0 (0%) | 35 (8.4%) |
| Bone marrow | 13 (5.2%) | 0 (0%) | 13 (3.1%) |
| Bone marrow, peripheral blood | 1 (0.4%) | 0 (0%) | 1 (0.2%) |
| Location of HCT | |||
| Inpatient | 216 (87%) | 109 (65%) | 325 (78%) |
| Outpatient | 32 (13%) | 59 (35%) | 91 (22%) |
| Donor relationship | |||
| Autologous | 0 (0%) | 168 (100%) | 168 (40%) |
| Matched | 176 (71%) | – | 176 (42%) |
| Haploidentical | 16 (6.5%) | – | 16 (4%) |
| Mismatched | 21 (8.5%) | – | 21 (5%) |
| Cord blood | 35 (14%) | – | 35 (8%) |
| Presence of acute GVHDb | 34 (14%) | – | 34 (8%) |
| Acute GVHD gradec | |||
| 1 | 1 (3%) | – | 1 (3%) |
| 2 | 27 (79%) | – | 27 (79%) |
| 3 | 5 (15%) | – | 5 (15%) |
| 4 | 1 (3%) | – | 1 (3%) |
| Prior history of CDId | 19 (8%) | 17 (10%) | 36 (9%) |
| Exposure to proton pump inhibitorse | 129 (52%) | 93 (55%) | 222 (54%) |
| Positive CMV serostatus at transplant | 148 (61%) | 102 (61%) | 250 (61%) |
| Diagnosis of CMV infectionf | 13 (5%) | 1 (1%) | 14 (3%) |
| Engraftment at CDI diagnosisg | 65 (26%) | 41 (24%) | 106 (25%) |
| Concomitant infection at CDI diagnosis | 64 (26%) | 18 (11%) | 82 (20%) |
| Exposure to antibiotics with anaerobic coverage | 37 (15%) | 27 (16%) | 64 (15%) |
| Initial CDI episode characteristics | |||
| Days from transplant to CDI median (range) | 3.5 (−7 to 97) | 6 (−5 to 93) | 5 (−7 to 97) |
| Feverh | 35 (15%) | 52 (33%) | 87 (22%) |
| WBC count cell/microliter median (range)i | 1495 (0–19,700) | 1060 (0–15,270) | 1245 (0–19,700) |
| Neutropeniaj | 84 (34%) | 77 (46%) | 161 (39%) |
| Treatment regimens used for index CDI | |||
| Oral vancomycin | 79 (31.9%) | 48 (28.6%) | 127 (30.5%) |
| Oral metronidazole | 61 (24.6%) | 45 (26.8%) | 106 (25.5%) |
| Oral and IV metronidazole | 25 (10%) | 28 (16.7%) | 53 (12.8%) |
| IV metronidazole | 7 (2.8%) | 3 (1.8%) | 10 (2.4%) |
| Oral vancomycin + metronidazole (IV or oral) | 75 (30%) | 44 (26.1%) | 119 (28.6) |
| Fidaxomicin | 1 (0.4%) | 0 (0) | 1 (0.2%) |
| Duration of treatment regimen for index CDI, median days (range) | 14 (4–34) | 14 (6–38) | 14 (4–38) |
Abbreviations: CDI, Clostridioides difficile infection; CMV, cytomegalovirus; GVHD, graft versus host disease; HCT, hematopoietic cell transplant; WBC, white blood cell.
aAmong n = 416 total patients. Numbers shown are n (%) unless otherwise specified. Numbers may not add to totals because of missing data, which composed <1% of the cohort for all variables except for fever, which was missing for 28 patients (7%).
bPresence of acute GVHD before or at initial CDI diagnosis.
cPercentages computed among those with acute GVHD.
dHistory of CDI within the last year before index CDI.
eExposure to proton pump inhibitors in the week before initial CDI diagnosis.
fDiagnosis of CMV infection/disease in the week before initial CDI diagnosis.
gEngraftment defined as 3 consecutive days of an absolute neutrophil count ≥500 cells/μL.
hTemperature ≥38 degrees Celsius within 24 hours before or after CDI diagnosis.
iNearest measurements before or at CDI diagnosis.
jWithin 48 hours before CDI diagnosis.
Baseline Patient Characteristics of HCT Patients With C Difficile Infectiona
| Characteristic Demographics and Clinical Characteristics . | Allogeneic HCT (n = 248) . | Autologous HCT (n = 168) . | All (n = 416) . |
|---|---|---|---|
| Age at HCT in years, median (range) | 53 (20–80) | 59 (19–74) | 56 (19–80) |
| Sex | |||
| Female | 107 (43%) | 71 (42%) | 178 (43%) |
| Male | 141 (57%) | 97 (58%) | 238 (57%) |
| Underlying malignancy | |||
| Acute leukemia | 176 (71%) | 1 (0.6%) | 177 (43%) |
| Chronic leukemia | 10 (4%) | 0 (0%) | 10 (2%) |
| Hodgkin lymphoma | 2 (0.8%) | 11 (7%) | 13 (3%) |
| Non-Hodgkin lymphoma | 4 (2%) | 50 (30%) | 54 (13%) |
| Myelodysplastic syndrome | 47 (19%) | 0 (0%) | 47 (11%) |
| Multiple myeloma | 1 (0.4%) | 93 (55%) | 94 (23%) |
| Other | 8 (3%) | 13 (8%) | 21 (5%) |
| Stem cell source | |||
| Peripheral blood | 199 (80.2%) | 168 (100%) | 367 (88.2%) |
| Cord | 35 (14.1%) | 0 (0%) | 35 (8.4%) |
| Bone marrow | 13 (5.2%) | 0 (0%) | 13 (3.1%) |
| Bone marrow, peripheral blood | 1 (0.4%) | 0 (0%) | 1 (0.2%) |
| Location of HCT | |||
| Inpatient | 216 (87%) | 109 (65%) | 325 (78%) |
| Outpatient | 32 (13%) | 59 (35%) | 91 (22%) |
| Donor relationship | |||
| Autologous | 0 (0%) | 168 (100%) | 168 (40%) |
| Matched | 176 (71%) | – | 176 (42%) |
| Haploidentical | 16 (6.5%) | – | 16 (4%) |
| Mismatched | 21 (8.5%) | – | 21 (5%) |
| Cord blood | 35 (14%) | – | 35 (8%) |
| Presence of acute GVHDb | 34 (14%) | – | 34 (8%) |
| Acute GVHD gradec | |||
| 1 | 1 (3%) | – | 1 (3%) |
| 2 | 27 (79%) | – | 27 (79%) |
| 3 | 5 (15%) | – | 5 (15%) |
| 4 | 1 (3%) | – | 1 (3%) |
| Prior history of CDId | 19 (8%) | 17 (10%) | 36 (9%) |
| Exposure to proton pump inhibitorse | 129 (52%) | 93 (55%) | 222 (54%) |
| Positive CMV serostatus at transplant | 148 (61%) | 102 (61%) | 250 (61%) |
| Diagnosis of CMV infectionf | 13 (5%) | 1 (1%) | 14 (3%) |
| Engraftment at CDI diagnosisg | 65 (26%) | 41 (24%) | 106 (25%) |
| Concomitant infection at CDI diagnosis | 64 (26%) | 18 (11%) | 82 (20%) |
| Exposure to antibiotics with anaerobic coverage | 37 (15%) | 27 (16%) | 64 (15%) |
| Initial CDI episode characteristics | |||
| Days from transplant to CDI median (range) | 3.5 (−7 to 97) | 6 (−5 to 93) | 5 (−7 to 97) |
| Feverh | 35 (15%) | 52 (33%) | 87 (22%) |
| WBC count cell/microliter median (range)i | 1495 (0–19,700) | 1060 (0–15,270) | 1245 (0–19,700) |
| Neutropeniaj | 84 (34%) | 77 (46%) | 161 (39%) |
| Treatment regimens used for index CDI | |||
| Oral vancomycin | 79 (31.9%) | 48 (28.6%) | 127 (30.5%) |
| Oral metronidazole | 61 (24.6%) | 45 (26.8%) | 106 (25.5%) |
| Oral and IV metronidazole | 25 (10%) | 28 (16.7%) | 53 (12.8%) |
| IV metronidazole | 7 (2.8%) | 3 (1.8%) | 10 (2.4%) |
| Oral vancomycin + metronidazole (IV or oral) | 75 (30%) | 44 (26.1%) | 119 (28.6) |
| Fidaxomicin | 1 (0.4%) | 0 (0) | 1 (0.2%) |
| Duration of treatment regimen for index CDI, median days (range) | 14 (4–34) | 14 (6–38) | 14 (4–38) |
| Characteristic Demographics and Clinical Characteristics . | Allogeneic HCT (n = 248) . | Autologous HCT (n = 168) . | All (n = 416) . |
|---|---|---|---|
| Age at HCT in years, median (range) | 53 (20–80) | 59 (19–74) | 56 (19–80) |
| Sex | |||
| Female | 107 (43%) | 71 (42%) | 178 (43%) |
| Male | 141 (57%) | 97 (58%) | 238 (57%) |
| Underlying malignancy | |||
| Acute leukemia | 176 (71%) | 1 (0.6%) | 177 (43%) |
| Chronic leukemia | 10 (4%) | 0 (0%) | 10 (2%) |
| Hodgkin lymphoma | 2 (0.8%) | 11 (7%) | 13 (3%) |
| Non-Hodgkin lymphoma | 4 (2%) | 50 (30%) | 54 (13%) |
| Myelodysplastic syndrome | 47 (19%) | 0 (0%) | 47 (11%) |
| Multiple myeloma | 1 (0.4%) | 93 (55%) | 94 (23%) |
| Other | 8 (3%) | 13 (8%) | 21 (5%) |
| Stem cell source | |||
| Peripheral blood | 199 (80.2%) | 168 (100%) | 367 (88.2%) |
| Cord | 35 (14.1%) | 0 (0%) | 35 (8.4%) |
| Bone marrow | 13 (5.2%) | 0 (0%) | 13 (3.1%) |
| Bone marrow, peripheral blood | 1 (0.4%) | 0 (0%) | 1 (0.2%) |
| Location of HCT | |||
| Inpatient | 216 (87%) | 109 (65%) | 325 (78%) |
| Outpatient | 32 (13%) | 59 (35%) | 91 (22%) |
| Donor relationship | |||
| Autologous | 0 (0%) | 168 (100%) | 168 (40%) |
| Matched | 176 (71%) | – | 176 (42%) |
| Haploidentical | 16 (6.5%) | – | 16 (4%) |
| Mismatched | 21 (8.5%) | – | 21 (5%) |
| Cord blood | 35 (14%) | – | 35 (8%) |
| Presence of acute GVHDb | 34 (14%) | – | 34 (8%) |
| Acute GVHD gradec | |||
| 1 | 1 (3%) | – | 1 (3%) |
| 2 | 27 (79%) | – | 27 (79%) |
| 3 | 5 (15%) | – | 5 (15%) |
| 4 | 1 (3%) | – | 1 (3%) |
| Prior history of CDId | 19 (8%) | 17 (10%) | 36 (9%) |
| Exposure to proton pump inhibitorse | 129 (52%) | 93 (55%) | 222 (54%) |
| Positive CMV serostatus at transplant | 148 (61%) | 102 (61%) | 250 (61%) |
| Diagnosis of CMV infectionf | 13 (5%) | 1 (1%) | 14 (3%) |
| Engraftment at CDI diagnosisg | 65 (26%) | 41 (24%) | 106 (25%) |
| Concomitant infection at CDI diagnosis | 64 (26%) | 18 (11%) | 82 (20%) |
| Exposure to antibiotics with anaerobic coverage | 37 (15%) | 27 (16%) | 64 (15%) |
| Initial CDI episode characteristics | |||
| Days from transplant to CDI median (range) | 3.5 (−7 to 97) | 6 (−5 to 93) | 5 (−7 to 97) |
| Feverh | 35 (15%) | 52 (33%) | 87 (22%) |
| WBC count cell/microliter median (range)i | 1495 (0–19,700) | 1060 (0–15,270) | 1245 (0–19,700) |
| Neutropeniaj | 84 (34%) | 77 (46%) | 161 (39%) |
| Treatment regimens used for index CDI | |||
| Oral vancomycin | 79 (31.9%) | 48 (28.6%) | 127 (30.5%) |
| Oral metronidazole | 61 (24.6%) | 45 (26.8%) | 106 (25.5%) |
| Oral and IV metronidazole | 25 (10%) | 28 (16.7%) | 53 (12.8%) |
| IV metronidazole | 7 (2.8%) | 3 (1.8%) | 10 (2.4%) |
| Oral vancomycin + metronidazole (IV or oral) | 75 (30%) | 44 (26.1%) | 119 (28.6) |
| Fidaxomicin | 1 (0.4%) | 0 (0) | 1 (0.2%) |
| Duration of treatment regimen for index CDI, median days (range) | 14 (4–34) | 14 (6–38) | 14 (4–38) |
Abbreviations: CDI, Clostridioides difficile infection; CMV, cytomegalovirus; GVHD, graft versus host disease; HCT, hematopoietic cell transplant; WBC, white blood cell.
aAmong n = 416 total patients. Numbers shown are n (%) unless otherwise specified. Numbers may not add to totals because of missing data, which composed <1% of the cohort for all variables except for fever, which was missing for 28 patients (7%).
bPresence of acute GVHD before or at initial CDI diagnosis.
cPercentages computed among those with acute GVHD.
dHistory of CDI within the last year before index CDI.
eExposure to proton pump inhibitors in the week before initial CDI diagnosis.
fDiagnosis of CMV infection/disease in the week before initial CDI diagnosis.
gEngraftment defined as 3 consecutive days of an absolute neutrophil count ≥500 cells/μL.
hTemperature ≥38 degrees Celsius within 24 hours before or after CDI diagnosis.
iNearest measurements before or at CDI diagnosis.
jWithin 48 hours before CDI diagnosis.
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