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Clinical Focus: Candida and Infectious Diseases - Review

Clostridium difficile infection in oncology patients: epidemiology, pathophysiology, risk factors, diagnosis, and treatment

ORCID Icon, , , &
Pages 266-277 | Received 16 May 2018, Accepted 04 Oct 2018, Published online: 15 Oct 2018

References

  • Neemann K, Freifeld A. Clostridium difficile–associated diarrhea in the oncology patient. J Oncol Pract. 2017;13(1):25–30.
  • Gupta A, Tariq R, Frank RD, et al. Trends in the incidence and outcomes of hospitalized cancer patients with Clostridium difficile infection: A nationwide analysis. J Natl Compr Canc Netw. 2017;15(4):466–472.
  • Khan A, Raza S, Batul SA, et al. The evolution of Clostridium difficile infection in cancer patients: epidemiology, pathophysiology, and guidelines for prevention and management. Recent Pat Antiinfect Drug Discov. 2012;7(2):157–170.
  • Martínez-Meléndez A, Camacho-Ortiz A, Morfin-Otero R. Current knowledge on the laboratory diagnosis of Clostridium difficile infection. World J Gastroenterol. 2017;23(9):1552–1567.
  • Hall IC, Intestinal OE. Fora in newborn infants with a description of a new pathogenic anaerobe, Bacillus difficile. Am J Dis Child. 1935;49:390–402.
  • Raza S, Baig MA, Russell H, et al. Clostridium difficile infection following chemotherapy. Recent Pat Antiinfect Drug Discov. 2010;5(1):1–9.
  • Bartlett JG, Chang TW, Gurwith M, et al. Antibiotic-associated pseudomembranous colitis due to toxin producing clostridia. N Engl J Med. 1978;298:531–534.
  • Kamthan AG, Bruckner HW, Hirschman SZ, et al. Clostridium difficile diarrhea induced by cancer chemotherapy. Arch Intern Med. 1992;152(8):1715–1717.
  • Lessa FC, Carolyn V, Clifford McDonald GL. Current Status of Clostridium difficile infection epidemiology. Clin Infect Dis. 2012;55(Suppl 2):S65–S70.
  • Gupta A, Khanna S. Community-acquired Clostridium difficile infection: an increasing public health threat. Infect Drug Resist. 2014;7:63–72.
  • Tai E, Richardson LC, Townsend J, et al. Clostridium difficile infection among children with cancer. Pediatr Infect Dis J. 2011;30(7):610–612.
  • Leffler DA, Lamont JT. Clostridium difficile infection. N Engl J Med. 2015;372(16):1539–1548.
  • Souza MH, Melo-Filho AA, Rocha MF, et al. The involvement of macrophage-derived tumour necrosis factor and lipoxygenase products on the neutrophil recruitment induced by Clostridium difficile toxin B. Immunology. 1997;91(2):281–288.
  • Bauer KA, Johnston JEW, Wenzler E, et al. Impact of the NAP-1 strain on disease severity, mortality, and recurrence of healthcare-associated Clostridium difficile infection. Anaerobe. 2017;48:1–6.
  • Cloud J, Noddin L, Pressman A. Clostridium difficile strain NAP-1 is not associated with severe disease in a nonepidemic setting. Clin Gastroenterol Hepatol. 2009;7(8):868–873.
  • Kamboj M, Xiao K, Kaltsas A, et al. Clostridium difficile infection after allogeneic hematopoietic stem cell transplant: strain diversity and outcomes associated with NAP1/027. Biol Blood Marrow Transplant. 2014;20:1626–1633.
  • Nomura K, Fujimoto Y, Yamashita M, et al. Absence of pseudomembranes in Clostridium difficile-associated diarrhea in patients using immunosuppression agents. Scand. J. Gastroenterol. 2009;44(1):74–78.
  • Scappaticci GB, Perissinotti AJ, Nagel JL, et al. Risk factors and impact of Clostridium difficile recurrence on haematology patients. J Antimicrob Chemother. 2017;72(5):1488–1495.
  • Chung MS, Kim J, Kang JO, et al. Impact of malignancy on Clostridium difficile infection. Eur J Clin Microbiol Infect Dis. 2016;35(11):1771–1776.
  • Chopra T, Chandrasekar P, Salimnia H, et al. Recent epidemiology of Clostridium difficile infection during hematopoietic stem cell transplantation. Clin Transplant. 2011;25(1):E82–7.
  • Delgado A, Reveles I, Cabello F, et al. Poorer outcomes among cancer patients diagnosed with Clostridium difficile infections in United States community hospitals. BMC Infectious Diseases. 2017;17:448.
  • Kamboj M, Son C, Cantu S, et al. Hospital-onset Clostridium difficile infection rates in persons with cancer or hematopoietic stem cell transplant: a C3IC network report. Infect Control Hosp Epidemiol. 2012;33(11):1162–1165.
  • Hebbard AI, Slavin MA, Reed C, et al. The epidemiology of Clostridium difficile infection in patients with cancer. Expert Rev Anti Infect Ther. 2016;14(11):1077–1085.
  • Brown KA, Khanafer N, Daneman N, et al. Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection. Antimicrob Agents Chemother. 2013;57(5):2326–2332.
  • Lewis S, Burmeister S, Brazier J. Effect of the prebiotic oligofructose on relapse of Clostridium difficile-associated diarrhea: a randomized, controlled study. Clin Gastroenterol Hepatol. 2005;3(5):442–448.
  • Dial S, Alrasadi K, Manoukian C, et al. Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case–control studies. Cmaj. 2004;171(1):33–38.
  • McCaleb RV, Gandhi AS, Clark SM, et al. Clinical outcomes of acid suppressive therapy use in hematology/oncology patients at an academic medical center. Ann Pharmacother. 2016;50(7):541–547.
  • Chul P, Ki-Eun H. Hak-Ryul H. Overview of Clostridium Difficile Infection in Cancer Patients. J Infect Dis Diagn. 2016;1:109.
  • Hebbard AIT, Slavin MA, Reed C, et al. Risks factors and outcomes of Clostridium difficile infection in patients with cancer: a matched case-control study. Support Care Cancer. 2017;25(6):1923–1930.
  • Mora AL, Salazar M, Pablo-Caeiro J, et al. Moderate to high use of opioid analgesics are associated with an increased risk of Clostridium difficile infection. Am J Med Sci. 2012;343(4):277–280.
  • Chang GY, Dembry LM, Banach DB. Epidemiology of Clostridium difficile infection in hospitalized oncology patients. Am J Infect Control. 2016;44(11):1408–1410.
  • Wang MS, Evans CT, Rodriguez T, et al. Clostridium difficile infection and limitations of markers for severity in patients with hematologic malignancy. Infect Control Hosp Epidemiol. 2013;34(2):127–132.
  • Peretz A, Shlomo IB, Nitzan O, et al. Clostridium difficile infection: associations with chemotherapy, radiation therapy, and targeting therapy treatments. Curr Med Chem. 2016;23(39):4442–4449.
  • Fuereder T, Koni D, Gleiss A, et al. Risk factors for Clostridium difficile infection in hemato-oncological patients: a case control study in 144 patients. Sci Rep. 2016;6:31498.
  • Anand A, Glatt AE. Clostridium difficile infection associated with antineoplastic chemotherapy: a review. Clin Infect Dis. 1993;17(1):109–113.
  • Morales Chamorro R, Serrano Blanch R, Méndez Vidal MJ, et al. Pseudomembranous colitis associated with chemotherapy with 5-fluorouracil. Clin Transl Oncol. 2005 7;Jul(6):258–261.
  • Nielsen H, Daugaard G, Tvede M, et al. High prevalence of Clostridium difficile diarrhoea during intensive chemotherapy for disseminated germ cell cancer. Br J Cancer. 1992;66(4):666–667.
  • Emoto M, Kawarabayashi T, Hachisuga MD. Clostridium difficile colitis associated with cisplatin-based chemotherapy in ovarian cancer patients. Gynecol Oncol. 1996;61(3):369–372.
  • Husain A, Aptaker L, Spriggs DR, et al. Gastrointestinal toxicity and Clostridium difficile diarrhea in patients treated with paclitaxel-containing chemotherapy regimens. Gynecol Oncol. 1998;71(1):104–107.
  • McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):e1–e48.
  • Debast SB, Bauer MP, Kuijper EJ, et al. European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. . Clin Microbiol Infect.. 2014;20(Suppl 2):1–26.
  • Woodworth MH, Kraft CS. Diagnostic and therapeutic considerations for oncology patients with Clostridium difficile infection. Journal of Oncology Practice. 2017;13(1):31–32.
  • Erb S, Frei R, Stranden AM, et al. Low sensitivity of fecal toxin A/B enzyme immunoassay for diagnosis of Clostridium difficile infection in immunocompromised patients. Clin Microbiol Infect. 2015;21(11):998.e9-998.e15.
  • Ö Y, Altındiş M, Cufalı D, et al. A diagnostic algorithm for the detection of Clostridium difficile-associated diarrhea. Balkan Med J. 2016;33(1):80–86.
  • Ticehurst JR, Aird DZ, Dam LM, et al. Effective detection of toxigenic Clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin. J Clin Microbiol. 2006;44(3):1145–1149.
  • Fenner L, Widmer AF, Goy G, et al. Rapid and reliable diagnostic algorithm for detection of Clostridium difficile. J Clin Microbiol. 2008;46(1):328–330.
  • Larson AM, Fung AM, Fang FC. Evaluation of tcdB real-time PCR in a three-step diagnostic algorithm for detection of toxigenic Clostridium difficile. J Clin Microbiol. 2010;48(1):124–130.
  • Surawicz CM, Brandt LJ, Binion DG, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013;108(4):478–498.
  • Zar FA, Bakkanagari SR, Moorthi KM, et al. A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis. 2007;45(3):302–307.
  • Belmares J, Gerding DN, Parada JP, et al. Outcome of metronidazole therapy for Clostridium difficile disease and correlation with a scoring system. J Infect. 2007;55(6):495–501.
  • Yoon YK, Kim MJ, Sohn JW, et al. Predictors of mortality attributable to Clostridium difficile infection in patients with underlying malignancy. Support. Care Cancer. 2014;22(8):2039–2048.
  • Parmar S, Bhatt V, Yang J, et al. A retrospective review of metronidazole and vancomycin in the management of Clostridium difficile infection in patients with hematologic malignancies. Journal of Oncology Pharmacy Practice. 2013;20(3):172–182.
  • Musher DM, Aslam S, Logan N, et al. Relatively poor outcome after treatment of Clostridium difficile colitis with metronidazole. Clin Infect Dis. 2005 Jun 1;40(11):1586–1590.
  • National Comprehensive Cancer Network. Prevention and Treatment of Cancer-Related Infections (Version I. 2018). https://www.nccn.org/professionals/physician_gls/PDF/infections.pdf. cited Apr 22, 2018
  • Louie TJ, Miller MA, Mullane KM, et al. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med. 2011;364(5):422–431.
  • Esmaily-Fard A, Tverdek F, Crowther D, et al. The use of fidaxomicin for treatment of relapsed Clostridium difficileI nfections in patients with cancer. Pharmacotherapy: the Journal of Human Pharmacology and Drug Therapy. 2014;34(11):1220–1225.
  • Comely OA, Miller MA, Fantin B, et al. Resolution of Clostridium difficile-associated diarrhea in patients with cancer treated with fidaxomicin or vancomycin. J Clin Oncol. 2013;31(19):2493–2499.
  • Mathur H, Rea MC, Cotter PD. The potential for emerging therapeutic options for Clostridium difficile infection. Gut Microbes. 2014;5(6):696–710.
  • Reveles KR, Backo JL, Corvino FA, et al. Fidaxomicin versus vancomycin as a first-line treatment for Clostridium difficile-associated diarrhea (CDAD) in specific patient populations: a pharmacoeconomic evaluation. Pharmacotherapy. 2017;37(12):1489–1497.
  • Rubio-Terrés C, Cobo Reinoso J, Grau Cerrato S, et al. Economic assessment of fidaxomicin for the treatment of Clostridium difficile infection (CDI) in special populations (patients with cancer, concomitant antibiotic treatment or renal impairment) in Spain. European Journal of Clinical Microbiology & Infectious Diseases. 2015;34(11):2213–2223.
  • Redman MG, Ward EJ, Phillips RS. The efficacy and safety of probiotics in people with cancer: a systematic review. Ann Oncol. 2014;25(10):1919–1929.
  • Martin J, Mawer D, Wilcox MH. Clostridium difficile: biological therapies. Curr Opin Infect Dis. 2013;26(5):454–460.
  • Shen NT, Maw A, Tmanova LL. Timely use of probiotics in hospitalized adults prevents Clostridium difficile infection: a systematic review with meta-regression analysis. Gastroenterology. 2017;152(8):1889–1900.
  • Osterlund P, Ruotsalainen T, Korpela R, et al. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study.Br. J Cancer. 2007;97(8):1028–1034.
  • Benchimol E, Mack D. Probiotics in relapsing and chronic diarrhea. Journal of Pediatric Hematology/Oncology. 2004;26(8):515–517.
  • Land MH, Rouster-Stevens K, Woods CR, et al. Lactobacillus sepsis associated with probiotic therapy. Pediatrics. 2005;115(1):178–181.
  • Cohen SA, Woodfield MC, Boyle N, et al. Incidence and outcomes of bloodstream infections among hematopoietic cell transplant recipients from species commonly reported to be in over-the-counter probiotic formulations. Transpl Infect Dis. 2016;18(5):699–705.
  • Garey KW, Salazar M, Shah D, et al. Rifamycin antibiotics for treatment of Clostridium difficile-associated diarrhea. Ann Pharmacother. 2008;42(6):827–835.
  • Basu PP, Dinani A, Rayapudi K, et al. Rifaximin therapy for metronidazole-unresponsive Clostridium difficile infection: a prospective pilot trial. Therap Adv Gastroenterol. 2010;3(4):221–225.
  • Garey KW, Ghantoji SS, Shah DN, et al. A randomized, double-blind, placebo-controlled pilot study to assess the ability of rifaximin to prevent recurrent diarrhoea in patients with Clostridium difficile infection. J Antimicrob Chemother. 2011;66(12):2850–2855.
  • Anton PM, O’Brien M, Kokkotou E. Rifalazil treats and prevents relapse of clostridium difficile-associated diarrhea in hamsters. Antimicrob Agents Chemother. 2004;48(10):3975–3979.
  • Nomura K, Matsumoto Y, Yoshida N, et al. Successful treatment with rifampin for fulminant antibiotics-associated colitis in a patient with non-Hodgkin’s lymphoma. World J Gastroenterol. 2004;10(5):765–766.
  • Warren CA, van Opstal E, Ballard TE, et al. Amixicile, a novel inhibitor of pyruvate: ferredoxin oxidoreductase, shows efficacy against Clostridium difficile in a mouse infection. model.Antimicrob Agents Chemother 2012;56(8):4103–4111.
  • Musher DM, Logan N, Bressler AM, et al. Nitazoxanide versus vancomycin in Clostridium difficile infection: a randomized, double-blind study. Clin Infect Dis. 2009;48(4):e41–6.
  • Popovic N, Korac M, Nesic Z, et al. Oral teicoplanin for successful treatment of severe refractory Clostridium difficile infection. J Infect Dev Ctries. 2015;9(10):1062–1067.
  • Wenisch C, Parschalk B, Hasenhündl M, et al. Comparison of vancomycin, teicoplanin, metronidazole, and fusidic acid for the treatment of Clostridium difficile-associated diarrhea. Clin Infect Dis. 1996 May;22(5):813–818.
  • Popovic N, Korac M, Nesic Z, et al. Oral teicoplanin versus oral vancomycin for the treatment of severe Clostridium difficile infection: a prospective observational study. Eur J Clin Microbiol Infect Dis. 2018 Apr;37(4):745–754.
  • Thomas A, Khan F, Uddin N, et al. Tigecycline for severe Clostridium difficile infection. Int J Infect Dis. 2014;26:171–172.
  • Brinda B, Pasikhova Y, Quilitz R, et al. Use of tigecycline for the management of Clostridium difficile colitis in oncology patients and case series of breakthrough infections. Journal of Hospital Infection. 2017;95(4):426–432.
  • Louie TJ, Peppe J, Watt CK, et al. Tolevamer, a novel nonantibiotic polymer, compared with vancomycin in the treatment of mild to moderately severe Clostridium difficile-associated diarrhea. Clin Infect Dis. 2006;43(4):411–420.
  • McCoy RM, Klick A, Hill S, et al. Luminal toxin-binding agents for Clostridium difficile Infection. J Pharm Pract. 2016;29(4):361–367.
  • Johnson S, Louie TJ, Gerding DN, et al. Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. Clin Infect Dis. 2014;59(3):345–354.
  • Shahani L, Koirala J, Intravenous immunoglobulin in treatment of Clostridium difficile colitis, Case Rep BMJ. 2012;2012. pii: bcr1020115052.
  • Shah N, Shaaban H, Spira R, et al. Intravenous immunoglobulin in the treatment of severe clostridium difficile colitis. J Glob Infect Dis. 2014;6(2):82–85.
  • Juang P, Skledar SJ, Zgheib NK. Clinical outcomes of intravenous immune globulin in severe clostridium difficile-associated diarrhea. Am J Infect Control. 2007;35(2):1.
  • Abougergi MS, Kwon JH. Intravenous immunoglobulin for the treatment of Clostridium difficile infection: a review. Dig Dis Sci. 2011;56(1):19–26.
  • Lee CH, Steiner T, Petrof EO, et al. Frozen vs fresh fecal microbiota transplantation and clinical resolution of diarrhea in patients with recurrent Clostridium difficile infection: a randomized clinical trial. JAMA. 2016;315(2):142–149.
  • Van, Nood E VA, Nieuwdorp M. Duodenal infusion of donor faeces for recurrent Clostridium difficile. N Engl J Med. 2013;368(5):407–415.
  • Di Bella S, Gouliouris T, Petrosillo N. Fecal microbiota transplantation (FMT) for Clostridium difficile infection: focus on immunocompromised patients. J Infect Chemother. 2015;21(4):230–237.
  • Webb BJ, Brunner A, Ford CD, et al. Fecal microbiota transplantation for recurrent Clostridium difficile infection in hematopoietic stem cell transplant recipients. Transpl Infect Dis. 2016;18(4):628–633.
  • Kali A, Charles MV, Cadazolid: SS. A new hope in the treatment of Clostridium difficile infection. Australas Med J. 2015;8(8):253–262.
  • Locher HH, Seiler P, Chen X, et al. In vitro and in vivo antibacterial evaluation of cadazolid, a new antibiotic for the treatment of Clostridium difficile infections: in vitro and in vivo antibacterial evaluation. Antimicrob Agents Chemother. 2014;58(2):892–900.
  • Locher HH, Caspers P, Bruyere T, et al. Investigations of the mode of action and resistance development of cadazolid, a new antibiotic for treatment of Clostridium difficile infections. Antimicrob Agents Chemother. 2014;58(2):901–908.
  • Louie T, Nord CE, Talbot GH, et al. Multicenter, double-blind, randomized, phase 2 study evaluating the novel antibiotic cadazolidin patients with Clostridium difficile Infection. Antimicrob Agents Chemother. 2015;59(10):6266–6273.
  • Basseres E, Endres BT, Dotson KM, et al. Novel antibiotics in development to treat Clostridium difficile infection. Curr Opin Gastroenterol. 2017;33(1):1–7.
  • Daley P, Louie T, Lutz JE, et al. .Surotomycin versus vancomycin in adults with Clostridium difficile infection: primary clinical outcomes from the second pivotal, randomized, double-blind, phase 3 trial. J Antimicrob Chemother. 2017;72(12):3462–3470.
  • Kraus CN, Lyerly MW, Carman RJ. .Ambush of Clostridium difficile spores by ramoplanin: activity in an in vitro model. Antimicrob Agents Chemother. 2015;59(5):2525–2530.
  • Freeman J, Baines SD, Wilcox MH. Comparison of the efficacy of ramoplanin vs vancomycin in both in vitro and in vivo models of clindamycin-induced Clostridium difficile infection. J Antimicrob Chemother. 2005;56(4):717–725.
  • Gerding DN, Meyer T, Lee C, et al. Administration of spores of nontoxigenic Clostridium difficile strain M3 for prevention of recurrent C. Difficile Infection: a Randomized Clinical Trial. JAMA.. 2015;313(17):1719–1727.
  • Valiquette L, Cossette B, Garant MP, et al. Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 Strain. Clin Infect Dis. 2007;45(Suppl 2):S112–21.
  • Carignan A, Poulin S, Martin P, et al. Efficacy of secondary prophylaxis with vancomycin for preventing recurrent Clostridium difficile infections. Am J Gastroenterol. 2016;111(12):1834–1840.
  • Van Hise NW, Bryant AM, Hennessey EK, et al. Efficacy of oral vancomycin in preventing recurrent Clostridium difficile infection in patients treated with systemic antimicrobial agents. Clin Infect Dis. 2016;63(5):651–653.
  • Wilcox MH, Gerding DN, Poxton IR, et al. Bezlotoxumab for prevention of recurrent Clostridium difficile infection. N Engl J Med. 2017;376(4):305–317.

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