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Updated: Feb 10, 2026
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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
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Risk factors associated with Clostridium difficile infection in kidney transplant recipients
M L Spinner1, B R Stephany2, P M Cerrato1
1Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA.
Summary
Kidney transplant recipients with higher tacrolimus levels and antibiotic use for urinary tract infections face increased Clostridium difficile infection (CDI) risk. Judicious antibiotic selection and tacrolimus management may reduce CDI incidence.
Area of Science:
- Nephrology
- Infectious Diseases
- Immunology
Background:
- Kidney transplant recipients (KTRs) are highly susceptible to Clostridium difficile infection (CDI) due to immunosuppression, healthcare exposure, and antibiotic use.
- Identifying specific risk factors for CDI in KTRs is crucial for effective prevention strategies.
Purpose of the Study:
- To identify risk factors for CDI in kidney transplant recipients.
- To investigate the role of immunosuppressive therapies and acid-suppressing agents in CDI development.
Main Methods:
- Retrospective case-control study involving 728 kidney transplant recipients from June 2009 to June 2013.
- 22 CDI cases were matched 1:3 with 66 controls, considering induction agent, allograft type, and time from transplant.
- Matched analysis controlled for key variables to isolate CDI risk factors.
Main Results:
- The overall incidence of CDI in kidney transplant recipients was 3%.
- Elevated average tacrolimus trough levels (AOR=1.25) and antibiotic exposure for urinary tract infections (UTIs) (AOR=4.17) were independently associated with CDI.
- Proton pump inhibitor use did not show a significant association with CDI development (OR=0.81).
Conclusions:
- Optimizing tacrolimus trough levels within a clinically appropriate range is essential for reducing CDI risk in KTRs.
- Judicious antibiotic use and careful selection for UTI treatment are critical to prevent CDI in this vulnerable population.
- Targeted interventions focusing on immunosuppression management and antibiotic stewardship can mitigate CDI incidence in kidney transplant recipients.
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