Validation of the SHEA/IDSA severity criteria to predict poor outcomes among inpatients and outpatients with <i>Clostridioides difficile</i> infection

Stevens, Vanessa; Shoemaker, Holly; Jones, Makoto; Jones, Barbara E.; Nelson, Richard E.; Khader, Karim; Samore, Matthew H.; Rubin, Michael

doi:10.1017/ice.2020.8

Cited by 5 publications

(5 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CPRs include a combination of various demographic (age), clinical (ICU stay, hypotension, abdominal tenderness, ileus, delirium, immunosuppression, narcotic, proton pump inhibitor (PPI) or systemic antibiotic use, liver disease, diabetes, and malignancy) and laboratory variables (serum WBC, albumin, creatinine, blood urea nitrogen, and C-reactive protein concentration). Despite performing well in internal validation, most of the tested CPRs for poor outcomes of CDI had suboptimal discriminatory function with area under the receiver operating characteristics curve values between 0.63 and 0.74 (66,67). Noting such limitations with CPR, the simplest and most widely known prediction rule was introduced by the 2010 IDSA guidelines (68).…”

Section: Key Conceptsmentioning

confidence: 99%

“…Validation of the 2010 and 2018 IDSA guidelines was recently performed using the VA healthcare system database, in >80,000 episodes of CDI capturing both inpatient and outpatient diagnoses, hospital and ICU admissions, colectomies, and 30-day all-cause mortality (66). Sensitivity ranged from 0.48 for ambulatory setting using the 2010 IDSA criteria to 0.73 for hospital setting using 2018 IDSA criteria.…”

Section: Classification Of CDImentioning

confidence: 99%

See 1 more Smart Citation

ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections

et al. 2021

View full text Add to dashboard Cite

Clostridioides difficile infection occurs when the bacterium produces toxin that causes diarrhea and inflammation of the colon. These guidelines indicate the preferred approach to the management of adults with C. difficile infection and represent the official practice recommendations of the American College of Gastroenterology. The scientific evidence for these guidelines was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation process. In instances where the evidence was not appropriate for Grading of Recommendations Assessment, Development, and Evaluation but there was consensus of significant clinical merit, key concept statements were developed using expert consensus. These guidelines are meant to be broadly applicable and should be viewed as the preferred, but not the only, approach to clinical scenarios.

show abstract

Section: Key Conceptsmentioning

confidence: 99%

Section: Classification Of CDImentioning

confidence: 99%

ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections

et al. 2021

View full text Add to dashboard Cite

show abstract

“…16 17 However, a predictive algorithm was unable to validate those criteria for identification of those with CDI who experienced ICU admission, colectomy, or death. 18 Several biomarkers are associated with severe disease and/or poor clinical outcomes, including fecal calprotectin, 19 serum procalcitonin, 20 serum albumin, 11 21 and serum eosinophils. 11 21 22 However, guidelines do not endorse the routine use of biomarkers to aid diagnosis until more evidence is available.…”

Section: Diagnosismentioning

confidence: 99%

Fulminant Clostridioides difficile Infection: A Review of Treatment Options for a Life-Threatening Infection

Carlson

Gonzales-Luna

Garey

2022

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Fulminant Clostridioides difficile infection (FCDI) encompasses 3 to 5% of all CDI cases with associated mortality rates between 30 and 40%. Major treatment modalities include surgery and medical management with antibiotic and nonantibiotic therapies. However, identification of patients with CDI that will progress to FCDI is difficult and makes it challenging to direct medical management and identify those who may benefit from surgery. Furthermore, since it is difficult to study such a critically ill population, data investigating treatment options are limited. Surgical management with diverting loop ileostomy (LI) instead of a total abdominal colectomy (TAC) with end ileostomy has several appealing advantages, and studies have not consistently demonstrated a clinical benefit with this less-invasive strategy, so both LI and TAC remain acceptable surgical options. Successful medical management of FCDI is complicated by pharmacokinetic changes that occur in critically ill patients, and there is an absence of high-quality studies that included patients with FCDI. Recommendations accordingly include a combination of antibiotics administered via multiple routes to ensure adequate drug concentrations in the colon: intravenous metronidazole, high-dose oral vancomycin, and rectal vancomycin. Although fidaxomicin is now recommended as first-line therapy for non-FCDI, there are limited clinical data to support its use in FCDI. Several nonantibiotic therapies, including fecal microbiota transplantation and intravenous immunoglobulin, have shown success as adjunctive therapies, but they are unlikely to be effective alone. In this review, we aim to summarize diagnosis and treatment options for FCDI.

show abstract

“…In addition, the study used the IDSA criteria for CDI severity, which require validation in the maintenance HD population. 9 Improving outcomes of CDI entails accurate recognition of factors associated with CDI and poor outcomes to optimize treatment and management decisions. This study identifies a subset of patients at higher risk for severe or fulminant CDI and modifiable risk factors associated with the severity of CDI and mortality.…”

mentioning

confidence: 99%

“…In addition, the study used the IDSA criteria for CDI severity, which require validation in the maintenance HD population. 9 …”

mentioning

confidence: 99%

Clostridioides difficile Infection Among Patients Requiring Maintenance Hemodialysis

Radhakrishnan

Shemin

et al. 2021

Kidney Medicine

View full text Add to dashboard Cite

Validation of the SHEA/IDSA severity criteria to predict poor outcomes among inpatients and outpatients with Clostridioides difficile infection

Cited by 5 publications

References 47 publications

ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections

ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections

Fulminant Clostridioides difficile Infection: A Review of Treatment Options for a Life-Threatening Infection

Clostridioides difficile Infection Among Patients Requiring Maintenance Hemodialysis

Contact Info

Product

Resources

About