{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:30:17Z","timestamp":1792225817610,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Chronic immunosuppression is a known cause of\n                      <jats:italic>Clostridioides difficile<\/jats:italic>\n                      , which presents with colon infection. It is associated with increased mortality and morbidity. Our aim is to determine the inpatient outcomes of liver transplant patients with\n                      <jats:italic>Clostridioides difficile<\/jats:italic>\n                      infection (CDI) and trends in the last few years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We utilized the national re\u2010admission data (2010\u20132017) to study the outcomes of CDI in liver transplant patients. Association of\n                      <jats:italic>C. difficile<\/jats:italic>\n                      with re\u2010admission was computed in a multivariable model adjusted for age, sex, gastrointestinal bleeding, hypertension, diabetes, hyperlipidemia, congestive heart failure, cerebrovascular disease, obesity, cancer, insurance, chronic kidney disease, chronic obstructive pulmonary disease, dementia, peripheral vascular disease, smoking, hospital location, and teaching status.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During 2010\u20132017, there were 310\u00a0222 liver transplant patients hospitalized. Out of these, 9826 had CDI. CDI infection in liver transplant patients was associated with higher 30\u2010day re\u2010admission (14.3% vs. 11.21%, hazard ratio [HR]: 1.14, 95% confidence interval [CI]: 1.01\u20131.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.02) and in\u2010hospital mortality (odds ratio [OR]: 1.36, 95% CI: 1.14\u20131.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). The most common causes of re\u2010admission in the CDI group were recurrent CDI (41.1%), liver transplant complications (16.5%), and sepsis (11.6%). The median cost for liver transplant patients with\n                      <jats:italic>C. difficile<\/jats:italic>\n                      was significantly higher, $53\u00a0064 (IQR $24\u00a0970\u2013$134\u00a0830) compared to patients that did not have\n                      <jats:italic>C. difficile<\/jats:italic>\n                      , $35\u00a0703 ($18\u00a0793\u2013$73\u00a0871) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001). The median length of stay was also longer for patients with CDI, 6\u00a0days (4\u201314) vs. 4\u00a0days (2\u20137) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CDI in post\u2010liver transplant patients was associated with higher mortality, re\u2010admission, health care cost, and longer length of stay. The most common cause of re\u2010admission was recurrent CDI, which raises the question of the efficacy of standard first\u2010line therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.13750","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T12:56:55Z","timestamp":1635166615000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The outcomes of\n                    <i>Clostridioides difficile<\/i>\n                    infection in inpatient liver transplant population"],"prefix":"10.1111","volume":"24","author":[{"given":"Waseem","family":"Amjad","sequence":"first","affiliation":[{"name":"Clinical Investigation Harvard Medical School  Boston Massachusetts USA"},{"name":"Internal Medicine Albany Medical Center  Albany New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waqas","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine University of Massachusetts  Worchester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Malik","sequence":"additional","affiliation":[{"name":"Internal Medicine Loyola Medical University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Singh","sequence":"additional","affiliation":[{"name":"Internal Medicine Indiana University  Fort Wayne Indiana USA"},{"name":"Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed\u2010Mohammed","family":"Jafri","sequence":"additional","affiliation":[{"name":"Gastroenterology and Transplant Hepatology Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1403772"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix1085"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408913"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy845"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-129-12-199812150-00004"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2217\/bmm.12.52"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1012413"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31824d34de"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2012.01568.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0124483"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu880"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2007.00530.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12798"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001309"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12855"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2011.08.098"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23449"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.12309"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001812"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2007.00255.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2016.08.006"},{"key":"e_1_2_7_23_1","unstructured":"Healthcare COST and Utilization Project (HCUP)The HCUP Nationwide Re\u2010admissions Database (NRD) 2014. 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