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Clostridium difficile colitis in children following lung transplantation

J B Rosen1, M G Schecter, J S Heinle

  • 1Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.

Pediatric Transplantation
|June 22, 2010
PubMed

Insights

Pediatric lung transplant recipients, especially those with cystic fibrosis (CF), face a significant risk of Clostridium difficile colitis (CDC). Early detection and management are crucial for improving outcomes in these vulnerable patients.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Immunology

Background:

  • Clostridium difficile infection (CDI) risk factors include antibiotics, hospitalization, and immunodeficiency.
  • Cystic Fibrosis (CF) patients exhibit high colonization rates with C. difficile.
  • Lung transplantation in pediatric patients, particularly those with CF, presents unique post-operative challenges.

Purpose of the Study:

  • To determine the incidence and outcomes of Clostridium difficile colitis (CDC) in pediatric lung transplant recipients.
  • To identify specific risk factors and clinical characteristics of CDC in this patient population.

Main Methods:

  • Retrospective chart review of pediatric lung transplant patients at Texas Children's Hospital from October 2002 to October 2008.
  • Analysis of patient demographics, transplant details, C. difficile diagnosis, treatment, and outcomes.

Main Results:

  • An overall incidence of 5.4% for CDC was observed among 78 pediatric lung transplants.
  • Patients with CF had a higher incidence of CDC (8.9%).
  • CDC occurred both early and late post-transplant, requiring hospitalization and varied medical/surgical interventions, with 75% survival.

Conclusions:

  • Clostridium difficile colitis poses a significant morbidity and mortality risk in pediatric lung transplant recipients, particularly those with cystic fibrosis.
  • The timing of CDC onset varied, underscoring the need for ongoing surveillance.
  • Aggressive management is essential to improve survival rates in this high-risk group.

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