BACKGROUND:Clostridioides difficile infection (CDI) is a significant cause of morbidity and mortality among hospitalized patients, particularly those who are immunosuppressed. We aim to assess the outcomes of CDI among kidney transplant (KT) recipients.
METHODS:Nationwide Inpatient Sample 2016-2020 was used to identify patients with KT and stratify based on presence of CDI. Data were collected regarding demographics and comorbidities. Outcomes included in-hospital mortality, acute kidney injury (AKI), intensive care unit (ICU) admission, transplant rejection, transplant failure, length of stay (LOS), and total hospitalization charges (THC). The relationships between variables of interest and outcomes were analyzed using multivariate regression.
RESULTS:A total of 557,635 KT recipients were included. CDI prevalence was 2.4%. Majority of patients in the CDI group were age >65 (43.6%), female (51%), White (55.3%), and had Medicare insurance (74.9%). On multivariate regression analysis, CDI was associated with increased odds of AKI (aOR 2.06, p<0.001), ICU admission (aOR 2.47, p<0.001), and mortality (aOR 1.90, p<0.001). CDI was also associated with longer LOS (9.35 days vs 5.42 days, p<0.001) and higher THC ($110,063 vs $100,006, p<0.001). There was no difference in transplant rejection, complication, failure, or infection among KT recipients with CDI and those without.
CONCLUSION:We found that CDI was associated with worse outcomes and higher costs. KT patients should be monitored closely for signs of CDI in order to initiate appropriate management.