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Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea Teja, Bijan; Alibhai, Nafeesa; Rubenfeld, Gordon D.; Taggart, Linda R.; Jivraj, Naheed; Hirji, Sameer A.; O’Gara, Brian P.; Shaefi, Shahzad

Abstract

While early empiric antibiotic therapy is beneficial for patients presenting with sepsis, the presentation of sepsis from Clostridioides difficile (formerly Clostridium difficile) infection (CDI) has not been well studied in large cohorts. We sought to determine whether the combination of extreme leukocytosis and diarrhea was strongly predictive of CDI in a cohort of 8659 patients admitted to the intensive care unit. We found that CDI was present in 15.0% (95% CI, 12.1–18.3%) of patients with extreme leukocytosis and diarrhea and that mortality for those with CDI, diarrhea, and extreme leukocytosis was 33.8% (95% CI, 23.2–44.3%). These data support consideration of empiric treatment for CDI in unstable critically ill patients with extreme leukocytosis and diarrhea, along with treatment of other possible sources of sepsis as appropriate. Empiric treatment for CDI can usually be discontinued promptly, along with narrowing of other broad-spectrum antimicrobial coverage, if a sensitive C. difficile test is negative.

Item Metadata

Title
Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea
Creator
Teja, Bijan; Alibhai, Nafeesa; Rubenfeld, Gordon D.; Taggart, Linda R.; Jivraj, Naheed; Hirji, Sameer A.; O’Gara, Brian P.; Shaefi, Shahzad
Publisher
Multidisciplinary Digital Publishing Institute
Date Issued
2021-01-01
Description
While early empiric antibiotic therapy is beneficial for patients presenting with sepsis, the presentation of sepsis from Clostridioides difficile (formerly Clostridium difficile) infection (CDI) has not been well studied in large cohorts. We sought to determine whether the combination of extreme leukocytosis and diarrhea was strongly predictive of CDI in a cohort of 8659 patients admitted to the intensive care unit. We found that CDI was present in 15.0% (95% CI, 12.1–18.3%) of patients with extreme leukocytosis and diarrhea and that mortality for those with CDI, diarrhea, and extreme leukocytosis was 33.8% (95% CI, 23.2–44.3%). These data support consideration of empiric treatment for CDI in unstable critically ill patients with extreme leukocytosis and diarrhea, along with treatment of other possible sources of sepsis as appropriate. Empiric treatment for CDI can usually be discontinued promptly, along with narrowing of other broad-spectrum antimicrobial coverage, if a sensitive C. difficile test is negative.
Subject
Clostridium difficile; Clostridioides difficile; leukocytosis; sepsis; critical care medicine
Genre
Article
Type
Text
Language
eng
Date Available
2021-03-26
Provider
Vancouver : University of British Columbia Library
Rights
CC BY 4.0
DOI
10.14288/1.0396389
URI
http://hdl.handle.net/2429/77633
Affiliation
Other UBC; Non UBC
Citation
Infectious Disease Reports 13 (1): 18-22 (2021)
Publisher DOI
10.3390/idr13010003
Peer Review Status
Reviewed
Scholarly Level
Faculty
Rights URI
https://creativecommons.org/licenses/by/4.0/
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DSpace

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CC BY 4.0