Characteristics of Clostridium difficile infection in patients hospitalized with myelodysplastic syndrome or acute myelogenous leukemia

Table 1 Characteristics of Patients with C. difficile infection n (%)

Variable (per patient)	CDI (n = 34)
Diagnosis
AML	31 (91)
MDS	3 (9)
Gender
Male	15 (44.1)
Female	19 (55.9)
PPI therapy1	22 (64.7)
Prior history of CDI	5 (14.8)
Receipt of chemotherapy2	31 (91)
Type of chemotherapy
Cytarabine-based chemotherapy	21 (61.7)
DNA hypomethylating agent-based chemotherapy	11 (32.3)
Death/referral to hospice	8 (23.5)
Severity of CDI3
Mild-moderate	29 (85.2)
Severe	4 (11.7)
Severe-complicated	1 (2.9)
Total number of CDI episodes during hospitalization
1	31 (91)
2	3 (9)
Recurrence of CDI	4 (11.7)
ICU admission	8 (23.5)
Bowel perforation	0
Need for surgical intervention	1 (3)

¹PPI therapy defined as use of PPI documented at the time of hospital admission;

²Receipt of chemotherapy defined as being given within 30 d of hospital admission;

³Severity as defined by the SHEA/IDSA Guidelines[12]. CDI: Clostridium difficile infection; AML: Acute myeloid leukemia; MDS: Myelodysplastic syndrome; PPI: Proton-pump inhibitor; ICU: Intensive care unit.

Table 2 Comparison of myelodysplastic syndrome and acute myeloid leukemia patients with and without Clostridium difficile infection n (%)

Variable	No CDI (n = 556)	CDI (n = 38)	Significance (P value)	No CDI (n = 189)	CDI (n = 34)	Significance (P value)
Per encounter analysis
Age on admission, mean (95%CI)	58.4 (57.0-59.8)	59.2 (54.6-63.9)	0.77
Albumin level (g/dL) on admission, mean (95%CI)	3.5 (3.4-3.5)	2.8 (2.6-3.1)	< 0.0001
AML (vs MDS) diagnosis	506 (91.0)	35 (92.1)	0.82
Male gender	338 (60.8)	18 (47.4)	0.1
Female gender	218 (39.2)	20 (52.63)	0.1
Use of PPI therapy1	206 (37.0)	13 (34.21)	0.73
Prior history of CDI	15 (2.7)	10 (23.32)	< 0.0001
Antibiotic use	465 (84)	31 (83)	0.66
Any chemotherapy2	438 (78.8)	35 (92.1)	0.048
Cytarabine-based chemotherapy2	253 (45.5)	25 (65.79)	0.015
DNA hypomethylating agent-based chemotherapy2 (n)	165 (29.7)	11 (29.0)	0.92
Other chemotherapy2	25 (4.5)	0 (0)	0.18
Death or referral to hospice	82 (14.8)	8 (21.05)	0.29
Per patient analysis
Total days of neutropenia during study period				13.7 (11.3-16.0)	21.6 (14.5-28.7)	0.014
Total days of hospitalization during study period				22.7 (19.9-25.5)	40.8 (28.9-52.7)	< 0.0001

¹PPI therapy defined as use of PPI documented at the time of hospital admission;

²Receipt of chemotherapy defined as being given within 30 d of hospital admission. CDI: Clostridium difficile infection; MDS: Myelodysplastic syndrome.