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 25 May 2016

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Clinical factors associated with complicated Clostridium difficile infection

The most recent issue of the Clinical Gastroenterology & Hepatology identifies clinical factors associated with development of severe-complicated Clostridium difficile infection.

News image

Clostridium difficile infection (CDI) can cause life-threatening complications.

Severe-complicated CDI is characterized by hypotension, shock, sepsis, ileus, megacolon, and colon perforation.

Dr Darrell Pardi and colleagues from Minnesota, USA created a model to identify clinical factors associated with severe-complicated CDI.

The researchers analyzed data from 1446 inpatient cases of CDI at the Mayo Clinic from 2007, to 2010.

Patients with severe-complicated CDI were identified as those who required admission to the intensive care unit or colectomy, or died, within 30 days of CDI diagnosis.

Increasing age is independently associated with severe-complicated CDI
Clinical Gastroenterology & Hepatology

Logistic regression models were used to identify variables that were independently associated with the occurrence of severe-complicated CDI in 2 cohorts.

The team reported that 1 cohort comprized all hospitalized patients.

The other comprised a subset of these inpatients who were residents of Olmsted County, Minnesota to assess the association of comorbid conditions with the development of severe-complicated infection in a population-based cohort.

The linear combinations of variables identified by using logistic regression models provided scores to predict the risk of developing severe-complicated CDI.

The research team found that increasing age, leukocyte count more than 15 × 109/L, increase in serum level of creatinine more than 1.5-fold from baseline, and use of proton pump inhibitors or narcotic medications were independently associated with severe-complicated CDI.

In the secondary analysis, which included only patients from Olmsted County, the research team found that comorbid conditions were not significantly associated with severe-complicated CDI.

Dr Pardi's team commented, "Older age, high numbers of leukocytes in blood samples, an increased serum level of creatinine, gastric acid suppression, and use of narcotic medications were independently associated with development of severe-complicated CDI in hospitalized patients."

"Early aggressive monitoring and intervention could improve outcomes."

Clin Gastroenterol Hepatol 2013: 11(11): 1466-1471
04 November 2013

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