Risk factors associated with Clostridium difficile infection in adult oncology patients. [artículo]
Por: Rodríguez Garzotto, Analía [Oncología Médica]
| Mérida García, Antonio [Oncología Médica] | Muñoz Unceta, Nerea [Oncología Médica] | Galera López, M. Mar [Oncología Médica] | Orellana Miguel, María Ángeles [Microbiología y Parasitología] | Díaz García, C. Vanesa [Instituto de Investigación i+12] | Cortijo Cascajares, Susana [Farmacia] | Cortés-Funes Castro, Hernán [Oncología Médica] | Agulló Ortuño, María Teresa [Oncología Médica].
Colaborador(es): Servicio de Oncología Médica | Instituto de Investigación imas12 | Servicio de Microbiología y Parasitología | Servicio de Farmacia Hospitalaria.
Tipo de material: 
ArtículoEditor: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2014Descripción: 23(6):1569-77.Recursos en línea: Solicitar documento Resumen: Purpose: Clostridium difficile infection (CDI) prevention is particularly important for cancer patients, because diarrhea often results in dose reductions or delays of chemotherapy or radiotherapy. We conducted this study to better ascertain the incidence, susceptibility, and risk factors for CDI in cancer patients receiving chemotherapy at our hospital.
Methods: We performed a retrospective study among adult cancer patients admitted at "12 de Octubre" University Hospital between January 2009 through April 2013 who were diagnosed with diarrhea. Inpatient data were available on hospital medical records. We screened by immunochromatography system detecting glutamate dehydrogenase antigen, and C. difficile toxins A and B. Later, a polymerase chain reaction for detecting toxin B gene was performed.
Results: A total of 225 patients were included in the study, and 39 of them (17.3 %) were diagnosed with CDI. Type of tumor significantly differed between CDI patients, thus relative risk in each type of cancer was calculated after adjusting for age, antibiotic exposure, corticosteroid, and proton-pump inhibitor use. Patients with gastrointestinal tumors were less prone to CDI. Conversely, breast cancer patients have a greater predisposition to CDI. Antibiotic treatment was found to be associated with an increasing risk for CDI in breast cancer patients. Curiously, exposure to proton-pump inhibitors appeared protective in our cohort, except for lung cancer patients. However, we have not been able to find an association between a particular type of chemotherapy and CDI.
Conclusions: We underscore the urgent need for early recognition and diagnosis of CDI in cancer patients. Our findings indicate a probable association between antibiotic use and CDI incidence, at least in certain cancer, such as breast cancer.
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Artículo
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Formato Vancouver:
Rodríguez Garzotto A, Mérida García A, Muñoz Unceta N, Galera López MM, Orellana Miguel MÁ, Díaz García CV et al. Risk factors associated with Clostridium difficile infection in adult oncology patients. Support Care Cancer. 2015 Jun;23(6):1569-77.
PMID: 25410088
Contiene 31 referencias
Purpose: Clostridium difficile infection (CDI) prevention is particularly important for cancer patients, because diarrhea often results in dose reductions or delays of chemotherapy or radiotherapy. We conducted this study to better ascertain the incidence, susceptibility, and risk factors for CDI in cancer patients receiving chemotherapy at our hospital.
Methods: We performed a retrospective study among adult cancer patients admitted at "12 de Octubre" University Hospital between January 2009 through April 2013 who were diagnosed with diarrhea. Inpatient data were available on hospital medical records. We screened by immunochromatography system detecting glutamate dehydrogenase antigen, and C. difficile toxins A and B. Later, a polymerase chain reaction for detecting toxin B gene was performed.
Results: A total of 225 patients were included in the study, and 39 of them (17.3 %) were diagnosed with CDI. Type of tumor significantly differed between CDI patients, thus relative risk in each type of cancer was calculated after adjusting for age, antibiotic exposure, corticosteroid, and proton-pump inhibitor use. Patients with gastrointestinal tumors were less prone to CDI. Conversely, breast cancer patients have a greater predisposition to CDI. Antibiotic treatment was found to be associated with an increasing risk for CDI in breast cancer patients. Curiously, exposure to proton-pump inhibitors appeared protective in our cohort, except for lung cancer patients. However, we have not been able to find an association between a particular type of chemotherapy and CDI.
Conclusions: We underscore the urgent need for early recognition and diagnosis of CDI in cancer patients. Our findings indicate a probable association between antibiotic use and CDI incidence, at least in certain cancer, such as breast cancer.
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