{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:27:17Z","timestamp":1753878437865,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,4,12]],"date-time":"2017-04-12T00:00:00Z","timestamp":1491955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We aimed to describe the epidemiology and outcomes of <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> in a national kidney transplant center from 2008 to 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult kidney and kidney\u2010pancreas transplant recipients were included for analysis if they met the surveillance <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> case definition. Rates of new healthcare\u2010associated <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content>) were expressed per 10\u00a0000 <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">KTPR<\/jats:styled-content> bed days used (<jats:styled-content style=\"fixed-case\">BDU<\/jats:styled-content>) to facilitate comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two cases of <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> were identified in 42 <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s and <jats:styled-content style=\"fixed-case\">KPTR<\/jats:styled-content>s. This corresponded to an average annual rate of 9.6 per 10\u00a0000 <jats:styled-content style=\"fixed-case\">BDU<\/jats:styled-content>, higher than that seen among general hospital inpatients locally, nationally, and internationally. Of the 45 cases (87%) that were considered <jats:styled-content style=\"fixed-case\">HA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content>, nine (20%) had symptom onset in the community. Recent proton\u2010pump inhibitor (<jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>) and broad\u2010spectrum antimicrobial exposure preceded the majority of cases. <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content>s and <jats:styled-content style=\"fixed-case\">KPTR<\/jats:styled-content>s with <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> had a longer mean length of hospital stay (35\u00a0days) than those <jats:styled-content style=\"fixed-case\">KTR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">KPTR<\/jats:styled-content>s admitted during the same period that did not have <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> (8\u00a0days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Education regarding <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> must be extended to transplant recipients and their general practitioners. Other targets for future <jats:styled-content style=\"fixed-case\">CDI<\/jats:styled-content> rate reduction must include stringent antimicrobial stewardship (both in hospital and in the community) and judicious <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> prescribing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12962","type":"journal-article","created":{"date-parts":[[2017,3,15]],"date-time":"2017-03-15T08:26:46Z","timestamp":1489566406000},"source":"Crossref","is-referenced-by-count":2,"title":["The epidemiology of <i>Clostridium difficile<\/i> infection in a national kidney transplant center"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7277-2171","authenticated-orcid":false,"given":"Claire","family":"Kennedy","sequence":"first","affiliation":[{"name":"Department of Nephrology Beaumont Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmel","family":"Waldron","sequence":"additional","affiliation":[{"name":"Department of Nephrology Beaumont Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mairead","family":"Skally","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Beaumont Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Gaughan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Beaumont Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colm","family":"Magee","sequence":"additional","affiliation":[{"name":"Department of Nephrology Beaumont Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Beaumont Hospital  Dublin Ireland"},{"name":"Health Protection Surveillance Centre  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fidelma","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Beaumont Hospital  Dublin Ireland"},{"name":"Department of Clinical Microbiology Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198901263200402"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1610-3"},{"key":"e_1_2_7_4_1","unstructured":"Available from:https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/491253\/CDRN_2013-15_Report.pdf."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/13.11.2842"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12030"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2014.11.018"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31824d34de"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2001.tb00050.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12418"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1086\/651706"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01120-13"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000430491"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12577"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2004.00433.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61266-4"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2012.00761.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13491"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12203"},{"key":"e_1_2_7_20_1","unstructured":"Surveillance Diagnosis and Management of Clostridium difficile Infection in Ireland.National Clinical Guideline No. 3. 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