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- Title
Renal Failure and Leukocytosis Are Predictors of a Complicated Course of Clostridium difficile Infection if Measured on Day of Diagnosis.
- Authors
Bauer, Martijn P.; Hensgens, Marjolein P. M.; Miller, Mark A.; Gerding, Dale N.; Wilcox, Mark H.; Dale, Adam P.; Fawley, Warren N.; Kuijper, Ed J.; Gorbach, Sherwood L.
- Abstract
Nonsevere Clostridium difficile infection (CDI) and severe CDI, which carries a higher risk than nonsevere CDI for treatment failure and CDI recurrence, are difficult to distinguish at the time of diagnosis. To investigate the prognostic value of 3 markers of severe CDI suggested by recent guidelines (fever, leukocytosis, and renal failure), we used the database of 2 randomized controlled trials, which contained information for 1105 patients with CDI. Leukocytosis (risk ratio [RR], 2.29; 95% confidence interval [CI], 1.63–3.21) and renal failure (RR, 2.52; 95% CI, 1.82–3.50) were associated with treatment failure. Fever, although associated with treatment failure (RR, 2.45; 95% CI, 1.07–5.61), was rare. Renal failure was the only significant predictor of recurrence (RR, 1.45; 95% CI, 1.05–2.02). Different timing of measurements of leukocyte count and serum creatinine level around the CDI diagnosis led to a different severity classification in many cases. In conclusion, both leukocytosis and renal failure are useful predictors, although timing of measurement is important.
- Subjects
KIDNEY failure; LEUCOCYTOSIS; CLOSTRIDIOIDES difficile; CLOSTRIDIUM diseases; CREATININE; CONFIDENCE intervals; DIAGNOSIS of bacterial diseases
- Publication
Clinical Infectious Diseases, 2012, Vol 55, Issue suppl_2, pS149
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/cis340