| Summary: | Objective To investigate the incidence and risk factors for Clostridium difficile infection (CDI) in patients with diarrhea during autologous hematopoietic stem cell transplantation (auto-HSCT) and provide guidance for clinical diagnosis and treatment. Methods Clinical data of patients with diarrhea during auto-HSCT between May 2005 and July 2019 were collected and retrospectively analyzed. The patients with positive results of Clostridium difficile anaerobic culture and Clostridium difficile toxin A/B test were assigned into the CDI group, and the others were into the non-CDI group. The incidence and risk factors for CDI were analyzed in this case-control study. Results A total of 202 patients developed diarrhea during auto-HSCT in this study. Thirty-three patients suffered from CDI, with an incidence rate of 16.3% and a median onset of 12(8~17) d since the admission of transplantation ward. The results of the univariate analysis indicated that the incidence of CDI was associated with the administration of busulfan, bortezomib and carmustine (all P < 0.05). The multivariate analysis showed that busulfan and bortezomib were the independent risk factors for CDI (all P < 0.05). The median time of diarrhea was 6(4~9) d in CDI patients, and 2 patients (6.0%) developed septic shock and died. Conclusion The incidence rate of CDI is quite high in the patients with diarrhea during auto-HSCT. The administration of busulfan and bortezomib are risk factors for CDI.
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