metricas
covid
Buscar en
Gastroenterología y Hepatología (English Edition)
Toda la web
Inicio Gastroenterología y Hepatología (English Edition) Recurrent Clostridium difficile infection treated with bezlotoxumab in a liver t...
Journal Information

Statistics

Follow this link to access the full text of the article

Scientific letter
Recurrent Clostridium difficile infection treated with bezlotoxumab in a liver transplant patient
Infección recurrente por Clostridium difficile tratada con bezlotoxumab en un paciente trasplantado hepático
María Hernándeza,
Corresponding author
mhernandezainsa@gmail.com

Corresponding author.
, Nuria Sauraa, Sandra Garcíaa, Raúl Velamazána, Daniel Abada, Gonzalo Hijosa, Enrique Alfaroa, Pablo Cañamaresb, Viviana Laredoa, Sara Lorentea
a Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
b Servicio de Aparato Digestivo, Hospital General San Jorge, Huesca, Spain
Read
289
Times
was read the article
55
Total PDF
234
Total HTML
Share statistics
 array:24 [
  "pii" => "S2444382421002212"
  "issn" => "24443824"
  "doi" => "10.1016/j.gastre.2020.09.010"
  "estado" => "S300"
  "fechaPublicacion" => "2021-12-01"
  "aid" => "1691"
  "copyright" => "Elsevier España, S.L.U.. All rights reserved"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Gastroenterol Hepatol. 2021;44:720-1"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210570520303964"
      "issn" => "02105705"
      "doi" => "10.1016/j.gastrohep.2020.09.015"
      "estado" => "S300"
      "fechaPublicacion" => "2021-12-01"
      "aid" => "1691"
      "copyright" => "Elsevier España, S.L.U."
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Gastroenterol Hepatol. 2021;44:720-1"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fica</span>"
        "titulo" => "Infecci&#243;n recurrente por <span class="elsevierStyleItalic">Clostridium difficile</span> tratada con bezlotoxumab en un paciente trasplantado hep&#225;tico"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "720"
            "paginaFinal" => "721"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Recurrent <span class="elsevierStyleItalic">Clostridium difficile</span> infection treated with bezlotoxumab in a liver transplant patient"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Mar&#237;a Hern&#225;ndez, Nuria Saura, Sandra Garc&#237;a, Ra&#250;l Velamaz&#225;n, Daniel Abad, Gonzalo Hijos, Enrique Alfaro, Pablo Ca&#241;amares, Viviana Laredo, Sara Lorente"
            "autores" => array:10 [
              0 => array:2 [
                "nombre" => "Mar&#237;a"
                "apellidos" => "Hern&#225;ndez"
              ]
              1 => array:2 [
                "nombre" => "Nuria"
                "apellidos" => "Saura"
              ]
              2 => array:2 [
                "nombre" => "Sandra"
                "apellidos" => "Garc&#237;a"
              ]
              3 => array:2 [
                "nombre" => "Ra&#250;l"
                "apellidos" => "Velamaz&#225;n"
              ]
              4 => array:2 [
                "nombre" => "Daniel"
                "apellidos" => "Abad"
              ]
              5 => array:2 [
                "nombre" => "Gonzalo"
                "apellidos" => "Hijos"
              ]
              6 => array:2 [
                "nombre" => "Enrique"
                "apellidos" => "Alfaro"
              ]
              7 => array:2 [
                "nombre" => "Pablo"
                "apellidos" => "Ca&#241;amares"
              ]
              8 => array:2 [
                "nombre" => "Viviana"
                "apellidos" => "Laredo"
              ]
              9 => array:2 [
                "nombre" => "Sara"
                "apellidos" => "Lorente"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2444382421002212"
          "doi" => "10.1016/j.gastre.2020.09.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382421002212?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570520303964?idApp=UINPBA00004N"
      "url" => "/02105705/0000004400000010/v1_202111240558/S0210570520303964/v1_202111240558/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2444382421002121"
    "issn" => "24443824"
    "doi" => "10.1016/j.gastre.2020.10.008"
    "estado" => "S300"
    "fechaPublicacion" => "2021-12-01"
    "aid" => "1672"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Gastroenterol Hepatol. 2021;44:721-3"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>"
      "titulo" => "Pericardial effusion associated with mesalamine treatment in a patient with ulcerative colitis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "721"
          "paginaFinal" => "723"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Derrame peric&#225;rdico asociado al tratamiento con mesalazina en un paciente con colitis ulcerosa"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1457
              "Ancho" => 2917
              "Tamanyo" => 268152
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#41; Four-chamber cine sequence showing normal-thickness pericardium with mild-moderate pericardial effusion&#46; &#40;B&#41; Late enhancement sequence showing absence of enhancement in pericardial leaves&#44; compatible with absence of active inflammation&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Alberto Ezquerra, Elena Resina, &#193;lvaro Montes, Tom&#225;s &#193;lvarez-Mal&#233;, Javier P&#46; Gisbert"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Alberto"
              "apellidos" => "Ezquerra"
            ]
            1 => array:2 [
              "nombre" => "Elena"
              "apellidos" => "Resina"
            ]
            2 => array:2 [
              "nombre" => "&#193;lvaro"
              "apellidos" => "Montes"
            ]
            3 => array:2 [
              "nombre" => "Tom&#225;s"
              "apellidos" => "&#193;lvarez-Mal&#233;"
            ]
            4 => array:2 [
              "nombre" => "Javier P&#46;"
              "apellidos" => "Gisbert"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210570520303770"
        "doi" => "10.1016/j.gastrohep.2020.10.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570520303770?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382421002121?idApp=UINPBA00004N"
    "url" => "/24443824/0000004400000010/v1_202112030713/S2444382421002121/v1_202112030713/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2444382421002145"
    "issn" => "24443824"
    "doi" => "10.1016/j.gastre.2021.10.001"
    "estado" => "S300"
    "fechaPublicacion" => "2021-12-01"
    "aid" => "1719"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Gastroenterol Hepatol. 2021;44:719-20"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>"
      "titulo" => "Intrahepatic cholestasis&#44; sometimes benign recurrent"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "719"
          "paginaFinal" => "720"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Colestasis intrahep&#225;tica&#46; A veces puede ser benigna y recurrente"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ruth Garc&#237;a-Romero, Laura Morlan-Herrador, Ignacio Ros-Arnal, Mar&#237;a Dolores Miramar, Cristina Molera-Busons"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Ruth"
              "apellidos" => "Garc&#237;a-Romero"
            ]
            1 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "Morlan-Herrador"
            ]
            2 => array:2 [
              "nombre" => "Ignacio"
              "apellidos" => "Ros-Arnal"
            ]
            3 => array:2 [
              "nombre" => "Mar&#237;a Dolores"
              "apellidos" => "Miramar"
            ]
            4 => array:2 [
              "nombre" => "Cristina"
              "apellidos" => "Molera-Busons"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210570520304441"
        "doi" => "10.1016/j.gastrohep.2020.10.015"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210570520304441?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382421002145?idApp=UINPBA00004N"
    "url" => "/24443824/0000004400000010/v1_202112030713/S2444382421002145/v1_202112030713/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>"
    "titulo" => "Recurrent <span class="elsevierStyleItalic">Clostridium difficile</span> infection treated with bezlotoxumab in a liver transplant patient"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "720"
        "paginaFinal" => "721"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Mar&#237;a Hern&#225;ndez, Nuria Saura, Sandra Garc&#237;a, Ra&#250;l Velamaz&#225;n, Daniel Abad, Gonzalo Hijos, Enrique Alfaro, Pablo Ca&#241;amares, Viviana Laredo, Sara Lorente"
        "autores" => array:10 [
          0 => array:4 [
            "nombre" => "Mar&#237;a"
            "apellidos" => "Hern&#225;ndez"
            "email" => array:1 [
              0 => "mhernandezainsa@gmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Nuria"
            "apellidos" => "Saura"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Sandra"
            "apellidos" => "Garc&#237;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Ra&#250;l"
            "apellidos" => "Velamaz&#225;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Daniel"
            "apellidos" => "Abad"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Gonzalo"
            "apellidos" => "Hijos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Enrique"
            "apellidos" => "Alfaro"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Pablo"
            "apellidos" => "Ca&#241;amares"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Viviana"
            "apellidos" => "Laredo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Sara"
            "apellidos" => "Lorente"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Aparato Digestivo&#44; Hospital Cl&#237;nico Universitario Lozano Blesa&#44; Zaragoza&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Aparato Digestivo&#44; Hospital General San Jorge&#44; Huesca&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Infecci&#243;n recurrente por <span class="elsevierStyleItalic">Clostridium difficile</span> tratada con bezlotoxumab en un paciente trasplantado hep&#225;tico"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Clostridium difficile</span> infection &#40;CDI&#41; is the leading cause of hospital-acquired diarrhoea and a growing cause of community-acquired diarrhoea&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It has a broad clinical spectrum&#44; and some patients with certain risk factors develop recurrent CDI &#40;rCDI&#41;&#46; These risk factors include&#58; advanced age&#44; immunosuppression&#44; chronic kidney disease&#44; concomitant use of antibiotics or of proton pump inhibitors &#40;PPIs&#41;&#44; prior episodes of CDI&#44; and presence of hypervirulent strains such as ribotypes 027 or 244&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">CDI treatment is based on antibiotics such as vancomycin&#44; fidaxomicin or metronidazole&#59; the latter is now considered inferior in terms of efficacy&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Faecal microbiota transplantation &#40;FMT&#41; also plays an important role&#44;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> as it reduces recurrence by 85&#37;&#8211;95&#37;&#46; Monoclonal antibodies represent a new approach to preventing recurrence&#46; These include bezlotoxumab&#44; which targets the micro-organism&#8217;s toxin B&#44; blocking its action and decreasing intestinal damage&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We report the case of a 62-year-old man with a medical history of&#58; hypertension&#59; Barret&#8217;s oesophagus&#59; liver transplantation in 2005 due to liver cirrhosis &#40;caused by hepatitis C virus and alcohol&#41;&#44; with recurrence of hepatitis C in the transplant in 2006 &#40;treated with direct-acting antivirals in 2015&#44; which achieved a sustained viral response&#41;&#44; evidence of advanced fibrosis in 2016 &#40;12&#46;5&#8239;kPa on elastography&#44; METAVIR score F3&#41;&#44; but with normal transplanted liver function parameters&#59; osteoporosis&#59; multifactorial chronic kidney disease &#40;stage G3a according to the KDIGO guidelines&#41;&#59; and two episodes of intraparenchymal cerebral haemorrhage in 2016 and 2017&#44; with secondary vascular epilepsy&#44; requiring prolonged hospital admission&#44; including a stay in the intensive care unit &#40;ICU&#41;&#46; His regular treatment consisted of mycophenolate mofetil &#40;500&#8239;mg&#47;8&#8239;h&#41;&#44; prednisone &#40;5&#8239;mg&#47;24&#8239;h&#41;&#44; levetiracetam&#44; pantoprazole and oral calcium&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In May 2017&#44; in the last months of admission for cerebral haemorrhage&#44; he had an initial episode of CDI that did not meet criteria to be considered severe&#46; He was treated with a regular regimen of oral vancomycin &#40;125&#8239;mg&#47;6&#8239;h for 10 days&#41;&#44; and his signs and symptoms resolved&#46; Two weeks later&#44; he had his first CDI recurrence&#44; which was again treated with vancomycin&#44; with a down-titration regimen at discharge&#46; In October 2017&#44; his second recurrence occurred&#59; he was given fidaxomicin 200&#8239;mg&#47;12&#8239;h for 10 days&#44; responding favourably&#46; Three months later&#44; the third recurrence occurred and&#44; after vancomycin treatment&#44; underwent a first FMT&#46; Despite this procedure&#44; he had further recurrences in February and April 2018&#44; and a decision was made to perform a second FMT&#46; In the months that followed&#44; the patient was admitted for new episodes&#44; which were treated with vancomycin&#46; With his eighth recurrence in March 2019&#44; it was decided to administer bezlotoxumab during the course of treatment with vancomycin&#46; It was administered in a single intravenous infusion for 60&#8239;min&#44; at a dose of 10&#8239;mg&#47;kg&#44; with no need to make adjustments based on kidney or liver function&#46; No short- or middle-term side effects were documented and&#44; after 12 months&#44; no new episodes of rCDI have occurred&#46; It should be noted that the initial episode and all recurrences were mild&#44; not meeting criteria for severity&#44; and accompanied by diarrhoea and mild worsening of kidney function on every occasion&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Several risk factors for recurrence of CDI converged in our patient&#58; advanced age&#44; immunosuppression&#44; chronic kidney disease&#44; PPI use and numerous recurrent episodes with exhaustion of available treatment options&#44; including two FMTs&#46; Treatment with bezlotoxumab is indicated in patients 18 years of age and older receiving treatment for CDI and at high risk of recurrence<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#59; in our case&#44; these criteria were fulfilled&#46; Bezlotoxumab is the first drug authorised to prevent rCDI&#44; and the results of the clinical trials conducted<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> confirm that it reduces recurrence rates&#46; However&#44; there is still no experience with repeat administration of the drug and there are still no data comparing it to other drugs&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Solid organ transplant recipients are under-represented in the majority of clinical trials and registry studies&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> They also have higher rates of morbidity and mortality due to their clinical condition&#44; their treatments and factors such as more frequent hospitalisations and greater use of antibiotics&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The choice of a specific treatment should be tailored to each patient&#8217;s condition and risk of recurrence&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Hern&#225;ndez M&#44; Saura N&#44; Garc&#237;a S&#44; Velamaz&#225;n R&#44; Abad D&#44; Hijos G&#44; et al&#46; Infecci&#243;n recurrente por <span class="elsevierStyleItalic">Clostridium difficile</span> tratada con bezlotoxumab en un paciente trasplantado hep&#225;tico&#46; Gastroenterol Hepatol&#46; 2021&#59;44&#58;720&#8211;721&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "<span class="elsevierStyleItalic">Clostridium difficile</span> infection&#58; review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Czepiel"
                            1 => "M&#46; Drozdz"
                            2 => "H&#46; Pituch"
                            3 => "E&#46;J&#46; Kuijper"
                            4 => "W&#46; Perucki"
                            5 => "A&#46; Mielimonka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur J Clin Microbiol Infect Dis"
                        "fecha" => "2019"
                        "volumen" => "38"
                        "paginaInicial" => "1211"
                        "paginaFinal" => "1221"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "<span class="elsevierStyleItalic">Clostridioides difficile</span> infection in immunocompromised hospitalized patients is associated with a high recurrence rate"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Avni"
                            1 => "T&#46; Babitch"
                            2 => "H&#46; Ben-Zvi"
                            3 => "R&#46; Hijazi"
                            4 => "G&#46; Ayada"
                            5 => "A&#46; Atamna"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijid.2019.10.028"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Infect Dis"
                        "fecha" => "2020"
                        "volumen" => "90"
                        "paginaInicial" => "237"
                        "paginaFinal" => "242"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31672656"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fecal microbiota transplantation for the treatment of recurrent and severe <span class="elsevierStyleItalic">Clostridium difficile</span> infection in solid organ transplant recipients&#58; a multicenter experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46;-W&#46; Cheng"
                            1 => "E&#46; Phelps"
                            2 => "V&#46; Ganapini"
                            3 => "N&#46; Khan"
                            4 => "F&#46; Ouyang"
                            5 => "H&#46; Xu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Transplant"
                        "fecha" => "2019"
                        "volumen" => "19"
                        "paginaInicial" => "501"
                        "paginaFinal" => "511"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Successful fecal microbiota transplantation in a patient with severe complicated <span class="elsevierStyleItalic">Clostridium difficile</span> infection after liver transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;M&#46; Schneider"
                            1 => "T&#46; Wirtz"
                            2 => "D&#46; Kroy"
                            3 => "S&#46; Albers"
                            4 => "U&#46;P&#46; Neumann"
                            5 => "T&#46; Strowig"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Case Rep Gastroenterol"
                        "fecha" => "2018"
                        "volumen" => "12"
                        "paginaInicial" => "76"
                        "paginaFinal" => "84"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bezlotoxumab for prevention of recurrent <span class="elsevierStyleItalic">Clostridium difficile</span> infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;H&#46; Wilcox"
                            1 => "D&#46;N&#46; Gerding"
                            2 => "I&#46;R&#46; Poxton"
                            3 => "C&#46; Kelly"
                            4 => "R&#46; Nathan"
                            5 => "T&#46; Birch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1602615"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2017"
                        "volumen" => "376"
                        "paginaInicial" => "305"
                        "paginaFinal" => "317"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28121498"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/24443824/0000004400000010/v1_202112030713/S2444382421002212/v1_202112030713/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "77930"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Scientific letter"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004400000010/v1_202112030713/S2444382421002212/v1_202112030713/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382421002212?idApp=UINPBA00004N"
]
Article information
ISSN: 24443824
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 2 0 2
2024 October 12 0 12
2024 September 29 5 34
2024 August 30 4 34
2024 July 17 6 23
2024 June 26 7 33
2024 May 20 3 23
2024 April 24 18 42
2024 March 14 3 17
2024 February 13 1 14
2024 January 27 4 31
2023 December 12 2 14
2023 October 1 0 1
2023 February 1 0 1
2023 January 1 2 3
2022 December 1 0 1
2022 November 1 0 1
2022 March 2 0 2
2021 December 1 0 1
Show all

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos