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Clostridium difficile is a major cause of diarrhea in thoracic organ transplant recipients. We investigated the epidemiology, risk factors, and outcome of Clostridium difficile infection (CDI) in heart and heart‐lung transplant (HT) recipients.

This is a retrospective study from 2004 to 2013. CDI was defined by diarrhea and a positive toxigenic C. difficile in stool measured by toxin enzyme immunoassay (2004‐2006) or polymerase chain reaction (2007‐2013). Cox proportional hazards regression was used to model the association of risk factors with time to CDI and survival with CDI following transplantation.

There were 254 HT recipients, with a median age of 53 years (IQR, 45‐60); 34% were female. During the median follow‐up of 3.1 years (IQR, 1.3‐6.1), 22 (8.7%) patients developed CDI. In multivariable analysis, risk factors for CDI were combined heart‐lung transplant (HR 4.70; 95 …