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Gastrointestinal Infections and Clostridium difficile Infection

  • Stephen Harold
  • Herbert L. DuPontEmail author
Chapter

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.

Keywords

Antibiotics Clostridium difficile Colonization Diarrhea Hypervirulence Immunosuppression Opportunistic Pseudomembrane Toxins 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Baylor College of MedicineHoustonUSA
  2. 2.Baylor St. Luke’s Medical Center, Department of ResearchHoustonUSA
  3. 3.Center for Infectious DiseasesUniversity of Texas School of Public HealthHoustonUSA
  4. 4.Kelsey Research FoundationHoustonUSA
  5. 5.University of Texas McGovern School of Medicine HoustonHoustonUSA

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