RT Journal Article
T1 Missed diagnosis of Clostridium difficile infection; a prospective evaluation of unselected stool samples
A1 Reigadas Ramírez, Elena Manuela
A1 Marín Arriaza, María De Las Mercedes
A1 Cortés Alcalá, Luis
A1 Burillo Albizua, Almudena
A1 Muñoz Carrasco, Patricia
A1 Bouza Santiago, Emilio
AB Background: Clostridium difficile infection (CDI) is the leading cause of hospital-acquired diarrhoea in developed countries, however a high proportion of CDI episodes go undiagnosed, either because physicians do not request identification of toxigenic C. difficile or microbiologists do not perform the appropriate tests.Objective: To investigate the clinical characteristics of patients with CDI within a non-selected population and to determine risk factors for clinical underdiagnosis.Methods: We conducted a prospective study in which systematic testing for toxigenic C. difficile on all diarrhoeic stool samples was performed regardless of the clinician's request. Patients aged >2 years positive for toxigenic C. difficile and diarrhoea were enrolled (Jan-June 2013) and monitored at least 2 months after their last episode.Results: We identified 204 cases of CDI, of which three-quarters were healthcare-associated. Most cases were mild to moderate (83.8%), the recurrence rate was 16.2%, and CDI-related mortality was low (2.5%). A significant proportion (12.7%) of CDI cases would have been missed owing to lack of clinical suspicion. Community-acquired cases and young age were risk factors for clinical underdiagnosis.Conclusion: Our data support the introduction of a systematic search for toxigenic C. difficile in all diarrhoeic stools from inpatients and outpatients older than 2 years.
PB Elsevier
SN 0163-4453
YR 2015
FD 2015-03
LK https://hdl.handle.net/20.500.14352/130100
UL https://hdl.handle.net/20.500.14352/130100
LA eng
NO Reigadas E, Alcalá L, Marín M, Burillo A, Muñoz P, Bouza E. Missed diagnosis of Clostridium difficile infection; a prospective evaluation of unselected stool samples. J Infect. 2015 Mar;70(3):264-72. doi: 10.1016/j.jinf.2014.10.013. Epub 2014 Nov 5. PMID: 25452039.
NO Fondo de Invetigaciones Sanitarias
DS Docta Complutense
RD 15 ene 2026