A contemporary review of Clostridioides difficile infections in patients with haematologic diseases

Clostridioides (Clostridium) difficile (C. difficile) infection is one of the most common causes of increased morbidity and mortality. Approximately 500 000 C. difficile infections (CDIs) occur each year in the United States, and they result in more than 29 000 deaths. Patients with haematologic dis...

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Bibliographic Details
Published inJournal of internal medicine Vol. 289; no. 3; pp. 293 - 308
Main Authors Dutta, D., Jafri, F., Stuhr, D., Knoll, B. M., Lim, S. H.
Format Journal Article
LanguageEnglish
Published England Blackwell Publishing Ltd 01.03.2021
Subjects
Antibiotics
Antiinfectives and antibacterials
Antimicrobial agents
Antimicrobial peptides
C. difficile infection
Chemoradiotherapy
Diseases
haematologic diseases
Health risks
Immunosuppression
Immunotherapy
Infections
intestinal dysbiosis
Microbiomes
Microbiota
Morbidity
Opioids
Peptides
Probiotics
Proton pump inhibitors
Risk analysis
Risk factors
Transplantation
Virulence
intestinal dysbiosis
C. difficile infection
haematologic diseases
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Summary:Clostridioides (Clostridium) difficile (C. difficile) infection is one of the most common causes of increased morbidity and mortality. Approximately 500 000 C. difficile infections (CDIs) occur each year in the United States, and they result in more than 29 000 deaths. Patients with haematologic diseases are at a higher risk for this infection due to frequent hospitalization and exposure to treatment‐associated risk factors. Whilst several currently available antimicrobial agents offer resolution, recurrence of infection remains a major concern. Recent advancement in deciphering C. difficile virulence mechanisms and identification of its allies in contributing to the infection has led to the development of alternative treatment strategies. Here, we will provide a contemporary discussion of how major risk factors in haematologic diseases, such as immunosuppression, chemoradiation, use of antibiotic, proton pump inhibitor and opioid, and deficiency in butyrate and antimicrobial peptides contribute to C. difficile infection. Next, we will highlight different approaches to control and mitigate this infection such as antibiotic stewardship and faecal microbiota transplantation. Finally, we will explore several emerging treatments such as use of pre‐ and probiotics, immunotherapy and microbiome‐sparing agents.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ObjectType-Review-1
ISSN:0954-6820
1365-2796
DOI:10.1111/joim.13173