A screening tool for Clostridium difficile

Clostridium difficile causes a bacterial infection that you do not want to get. At best, it causes severe diarrhea, and at worst it can kill you. Normally, C. difficile is held in check by the ‘friendly’ bacteria in a person’s gut, but following antibiotic treatment, the good microbes are often decimated, leaving room for C. difficile to flourish. This means that it’s a particular problem for people who are already trying to recover from a prior illness.

Clostridium difficile 

To make matters worse, C. difficile is often antibiotic-resistant. Even when antibiotics appear to clear the infection, it recurs in 20% of individuals. This means that some people need to be treated extremely aggressively to save their lives. But which ones? 

As Ray Sheridan of Royal Devon and Exeter NHS Foundation Trust explains:

It's important to get the [right] treatment: too much treatment may see new antibiotic resistant strains emerge; too little and patients might die. 

Emma Butt of the University of Exeter and her colleagues have developed an easy way to assess which patients are most at risk for mortality or recurrence.

The scientists began with 186 different variables and narrowed their list down to the four most useful ones: 

• Serum albumin levels 
• respiratory rate 
• C-reactive protein levels
• white cell count 

By using these four simple parameters, doctors can screen the patients who will need more intensive intervention. Then, it’s time for the fecal transplants.

Emma Butt, Jane AH Foster, Edward Keedwell, Julia EA Bell, Richard W Titball, Aneel Bhangu, Stephen L Michell, & Ray Sheridan (2013). Derivation and validation of a simple, accurate and robust prediction rule for risk of mortality in patients with Clostridium difficile infection BMC Infectious Diseases, 13 (316) DOI: 10.1186/1471-2334-13-316.