MONDAY, JUNE 18, 2018

Researchers identify four-point test to predict C. difficile death risk

British researchers identified a unique four-point test that can accurately predict the death risk to patients from an infection of Clostridium difficile, according to a study published on Friday in BMC Infectious Diseases.

C. difficile is an infection that most commonly affects hospital patients and may infect individuals on antibiotics who have an imbalance of good bacteria in the gut. The test uses easily measurable clinical variables to make accurate predictions of patient risk to manage the at-risk patients accordingly by a clinical team.

Researchers with the University of Exeter, the Royal Devon & Exeter National Health Service Foundation Trust and the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula developed the test using an analysis of the clinical notes of 213 patients transferred to RD&E's specialized C. difficile ward between 2007 and 2009. The researchers determined the test should examine the serum albumin levels, respiratory rate, C-reactive protein levels and white cell count of patients to determine death risk.

"Our findings are exciting because they identify a simple, accurate and robust method to identify those patients who are at risk of dying from a C. diff infection," Steve Michell, the joint lead author of the study, said. "The clinical variables identified are easily measurable, using tests that are commonly carried out in hospital. The results of our study strengthen the evidence for establishing the use of this rule in clinical settings: the benefits to patient well-being, the efficient management of infection in hospital and potential savings to the NHS and other health services around the world, would be immense."

Ray Sheridan, a consultant physician at the RD&E said that patients with C. difficile are frequently much more sick than they first appear. The lack of outward symptoms make it tough for non-specialists to determine how ill patients are and when appropriate treatment should begin.

"This really simple and quick tool, which any junior doctor could use in the middle of the night quickly and easily, flags up those who need a speedy and intensive treatment regime or more senior help," Sheridan said. "The quicker we get on with the right treatment for the right patient the better their chances of recovery are. This is a tool that should be used in every hospital in the U.K. as soon as possible: if we did so we would save more lives."

C. difficile-related deaths made up 1.1 percent of all deaths in England and Wales between 2010. There were 17,414 reported cases of infections in England in 2011.