2026-06-01T02:13:13Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/1301002026-01-14T01:18:53Zcom_20.500.14352_14col_20.500.14352_15

Missed diagnosis of Clostridium difficile infection; a prospective evaluation of unselected stool samples Reigadas Ramírez, Elena Manuela Marín Arriaza, María De Las Mercedes Cortés Alcalá, Luis Burillo Albizua, Almudena Muñoz Carrasco, Patricia Bouza Santiago, Emilio 616.1/.9 C. difficile infection UnderdiagnosisHealthcare associated Community associated Recurrence Medicina 32 Ciencias Médicas 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. Fondo de Invetigaciones Sanitarias Depto. de Medicina Fac. de Medicina TRUE pub 2026-01-13T16:18:23Z 2026-01-13T16:18:23Z 2015-03 journal article VoR https://hdl.handle.net/20.500.14352/130100 0163-4453 10.1016/j.jinf.2014.10.013 eng PI13/00687 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. Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ restricted access application/pdf Elsevier