Risk Factors for Clostridium Difficile Colitis in Patients Undergoing Treatment for Gynecologic Cancer

Blake EA, Sheeder J, Carrubba A, Okland T, Doo D and Guntupalli S

Department of Obstetrics and Gynecology, University of Colorado, USA
Department of Obstetrics and Gynecology, University of Colorado School of Medicine, USA

^*Correspondance to: Blake EA 

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Abstract:

Objectives: Clostridium Difficile Associated Diarrhea (CDAD) is a common potentially dangerous complication of treatment for gynecologic cancers and is an important metric for quality of hospital care. We evaluated risk factors associated with CDAD in gynecologic oncology patients.
Design: Retrospective chart review Setting: Inpatient gynecologic oncology ward Patients: Women with histological confirmation of a gynecologic malignancy admitted for >24 hours were abstracted at a tertiary referral center over four years. Both surgical and medical admissions included.
Methods: Details regarding health status and treatments were abstracted. Diagnosis of CDAD was made witha positive PCR result. Standard statistical tests were used.
Results: A total of 728 women were included. Fifteen patients had positive PCR proven CDAD (2.01%). In bivariate analysis, cephalosporin exposure (OR 0.21, 95% CI 0.06-0.74) and surgical admission (OR 0.28, 95% CI 0.09- 0.87) were associated with decreased risk of CDAD. Platinum based chemotherapy use (OR 3.61, 95% CI 1.29-10.13), radiation therapy (OR 6.82, 95% CI 1.81- 25.7), and early stage (OR 3.59, 95% CI 1.26-10.21) were associated with increased risk of CDAD. In logistic regression analysis, chemotherapy use (aOR 5.7, 95% CI 1.91-17.10) and early stage disease (aOR 5.7, 95% CI 1.22-11.05), were found to be independent predictors of CDAD. Cephalosporin use was independently found to be associated with decreased risk of CDAD (aOR 0.20, 95% CI 0.05-0.75). Conclusions: Platinum based chemotherapies and early stage disease are significant risk factors for the development of CDAD in gynecologic oncology patients. Attention to these risk factors is warranted to prevent the dangerous sequelae of infection with this organism.

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Cite the Article:

Blake EA, Sheeder J, Carrubba A, Okland T, Doo D, Guntupalli S. Risk Factors for Clostridium Difficile Colitis in Patients Undergoing Treatment for Gynecologic Cancer. Clin Oncol. 2017; 2: 1190.