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Principles and Practice of Transplant Infectious Diseases pp 291–301Cite as

Gastrointestinal Infections and Clostridium difficile Infection

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Abstract

In recent years, extensive research and newer therapeutic strategies have remarkably reduced the number of acute and chronic rejections and graft-versus-host disease (GVHD) and have significantly improved the survival of transplant recipients. On the other hand, transplant recipients are more vulnerable to a wide range of infections as immunosuppressive therapies not only suppress host T-cell response but also destroy other rapidly dividing cells resulting in neutropenia and hypogammaglobulinemia. In the first 6 months following transplantation, gastrointestinal infections due to cytomegalovirus, herpes simplex virus, or Candida albicans are common. But, with prolonged and frequent hospital stay, long waiting times, advanced age, hypogammaglobulinemia, and systemic diseases like diabetes and renal insufficiency, the incidence of Clostridium difficile (C. difficile) infections (CDI) is on the rise and is the most commonly identified cause of enteric infections in liver transplant recipients. The changes in the incidence and severity of infection due to emergence of a hypervirulent strain of C. difficile bacteria and the associated healthcare cost represent a significant healthcare facility-associated public health problem. However, simple procedures such as environmental disinfection, hand hygiene, and other enteric precautions are very effective in minimizing the incidence of CDI. In this chapter, we present an overview of CDI as early diagnosis and prompt treatment strategies with newer drugs can help reduce morbidity and mortality due to CDI and eventually organ rejection and GVHD in this special population.

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Authors and Affiliations

  1. Baylor College of Medicine, Houston, TX, USA

    Stephen Harold & Herbert L. DuPont

  2. Baylor St. Luke’s Medical Center, Department of Research, Houston, TX, USA

    Herbert L. DuPont

  3. Center for Infectious Diseases, University of Texas School of Public Health, Houston, TX, USA

    Herbert L. DuPont

  4. Kelsey Research Foundation, Houston, TX, USA

    Herbert L. DuPont

  5. University of Texas McGovern School of Medicine Houston, Houston, TX, USA

    Herbert L. DuPont

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    Amar Safdar

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Harold, S., DuPont, H.L. (2019). Gastrointestinal Infections and Clostridium difficile Infection. In: Safdar, A. (eds) Principles and Practice of Transplant Infectious Diseases. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-9034-4_16

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