Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 19;12(1):37.
doi: 10.3390/pharmacy12010037.

Development of a Prediction Model to Identify the Risk of Clostridioides difficile Infection in Hospitalized Patients Receiving at Least One Dose of Antibiotics

Abdulrahman Alamri  1   2   3 , AlHanoof Bin Abbas  4 , Ekram Al Hassan  5 , Yasser Almogbel  4
Affiliations

Development of a Prediction Model to Identify the Risk of Clostridioides difficile Infection in Hospitalized Patients Receiving at Least One Dose of Antibiotics

Abdulrahman Alamri et al. Pharmacy (Basel). .

Abstract

Objective: This study's objective was to develop a risk-prediction model to identify hospitalized patients at risk of Clostridioides difficile infection (CDI) who had received at least one dose of systemic antibiotics in a large tertiary hospital.

Patients and methods: This was a retrospective case-control study that included patients hospitalized for more than 2 days who received antibiotic therapy during hospitalization. The study included two groups: patients diagnosed with hospital CDI and controls without hospital CDI. Cases were matched 1:3 with assigned controls by age and sex. Descriptive statistics were used to identify the study population by comparing cases with controls. Continuous variables were stated as the means and standard deviations. A multivariate analysis was built to identify the significantly associated covariates between cases and controls for CDI.

Results: A total of 364 patients were included and distributed between the two groups. The control group included 273 patients, and the case group included 91 patients. The risk factors for CDI were investigated, with only significant risks identified and included in the risk assessment model: age older than 70 years (p = 0.034), chronic kidney disease (p = 0.043), solid organ transplantation (p = 0.021), and lymphoma or leukemia (p = 0.019). A risk score of ≥2 showed the best sensitivity, specificity, and accuracy of 78.02%, 45.42%, and 78.02, respectively, with an area under the curve of 0.6172.

Conclusion: We identified four associated risk factors in the risk-prediction model. The tool showed good discrimination that might help predict, identify, and evaluate hospitalized patients at risk of developing CDI.

Keywords: chronic kidney disease; clostridioides difficile infection; clostridium difficile infection; clostridium difficile infection risk factors; model; risk prediction.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Inclusion flowcharts of cases and controls.
Figure 2
Figure 2
Receiver operating characteristic for the total score.
Figure 3
Figure 3
Receiver operating characteristic curve of score ≥2.
Figure 4
Figure 4
Receiver operating characteristic curve of score ≥4.
Figure 5
Figure 5
Receiver operating characteristic curve of score ≥6.
Figure 6
Figure 6
Receiver operating characteristic curve of score ≥8.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Smits W.K., Lyras D., Lacy D.B., Wilcox M.H., Kuijper E.J. Clostridium difficile infection. Nat. Rev. Dis. Primers. 2016;2:16020. doi: 10.1038/nrdp.2016.20. - DOI - PMC - PubMed
    1. George R.H., Symonds J.M., Dimock F., Brown J.D., Arabi Y., Shinagawa N., Keighley M.R., Alexander-Williams J., Burdon D.W. Identification of Clostridium difficile as a cause of pseudomembranous colitis. Br. Med. J. 1978;1:695. doi: 10.1136/bmj.1.6114.695. - DOI - PMC - PubMed
    1. Sunenshine R.H., McDonald L.C. Clostridium difficile-associated disease: New challenges from an established pathogen. Cleve. Clin. J. Med. 2006;73:187–197. doi: 10.3949/ccjm.73.2.187. - DOI - PubMed
    1. Oliveira P.H., Fang G. Conserved DNA methyltransferases: A window into fundamental mechanisms of epigenetic regulation in bacteria. Trends Microbiol. 2021;29:28–40. doi: 10.1016/j.tim.2020.04.007. - DOI - PMC - PubMed
    1. McDonald L.C., Gerding D.N., Johnson S., Bakken J.S., Carroll K.C., Coffin S.E., Dubberke E.R., Garey K.W., Gould C.V., Kelly C., et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) Clin. Infect. Dis. 2018;66:987–994. doi: 10.1093/cid/ciy149. - DOI - PubMed

LinkOut - more resources