5 factors to predict patients' C. diff risk

A group of factors could predict which patients are likely to develop Clostridium difficile and help providers prevent the infection, a study published in Science Translational Medicine found.

The research included studies in both humans and mice and involved transplanting feces from human study participants to mice to evaluate differences in C. diff susceptibility and explanations for increased infection risk.

The researchers began by assessing the gut microbes of a group of 115 people who had diarrhea but who did not have C. diff when they first sought treatment. Some of these patients later developed a C. diff infection. For comparison, the researchers also analyzed the gut microbes of 118 healthy volunteers.

The researchers then looked at potential risk factors on the medical charts of patients with unhealthy and healthy-looking gut microbial communities and found a cluster of five factors linked to unhealthy communities.

"We knew that [unhealthy] microbial communities put mice at higher risk of C. diff infection, and we wanted to see if the five factors could be used to predict C. diff infections in humans," said the study's co-lead author, Vanessa Hale, PhD.

To do this, the researchers looked at the medical charts of more than 17,000 previous patients who did not have C. diff when initially seeking care. They also found a clear link in that larger group between the five risk factors and subsequent C. diff infection.

The five factors that predicted patients' risk of subsequent infection were reduced immune function, recent antibiotic use, current hospitalization, recent hospitalization and prior C. diff infection.

"This could help healthcare providers red-flag those patients who are at high risk of C. diff and may one day lead to therapeutic or dietary tactics to lower the chances of infection," Dr. Hale said.

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