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Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea
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 le...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839043/ https://www.ncbi.nlm.nih.gov/pubmed/33401377 http://dx.doi.org/10.3390/idr13010003 |
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author | Teja, Bijan Alibhai, Nafeesa Rubenfeld, Gordon D. Taggart, Linda R. Jivraj, Naheed Hirji, Sameer A. O’Gara, Brian P. Shaefi, Shahzad |
author_facet | Teja, Bijan Alibhai, Nafeesa Rubenfeld, Gordon D. Taggart, Linda R. Jivraj, Naheed Hirji, Sameer A. O’Gara, Brian P. Shaefi, Shahzad |
author_sort | Teja, Bijan |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-7839043 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78390432021-01-28 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 Infect Dis Rep Article 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. MDPI 2021-01-01 /pmc/articles/PMC7839043/ /pubmed/33401377 http://dx.doi.org/10.3390/idr13010003 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Teja, Bijan Alibhai, Nafeesa Rubenfeld, Gordon D. Taggart, Linda R. Jivraj, Naheed Hirji, Sameer A. O’Gara, Brian P. Shaefi, Shahzad Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea |
title | Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea |
title_full | Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea |
title_fullStr | Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea |
title_full_unstemmed | Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea |
title_short | Prevalence of Clostridioides difficile Infection in Critically Ill Patients with Extreme Leukocytosis and Diarrhea |
title_sort | prevalence of clostridioides difficile infection in critically ill patients with extreme leukocytosis and diarrhea |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839043/ https://www.ncbi.nlm.nih.gov/pubmed/33401377 http://dx.doi.org/10.3390/idr13010003 |
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