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Harbingers for Clostridium difficile-associated diarrhea

Chaitanya Pant1, Phillip N Madonia, Paul Jordan

  • 1Department of Medicine, Louisiana State University Health Science Center, Shreveport, LA, USA. cpant@lsuhsc.edu

Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research
|December 19, 2008
PubMed

Insights

Elevated white blood cell and platelet counts, along with low albumin levels, are reliable indicators for diagnosing Clostridium difficile-associated diarrhea (CDAD) in hospitalized patients. This study confirms these markers even after excluding confounding hematologic disorders.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Clinical Pathology

Background:

  • Clostridium difficile-associated diarrhea (CDAD) diagnosis relies on clinical symptoms and laboratory tests.
  • Previous studies identified leukocyte count, platelet count, and albumin level as potential surrogate markers for CDAD.
  • Confounding factors, such as hematologic disorders, were not always excluded in prior research.

Purpose of the Study:

  • To evaluate the reliability of leukocyte count, platelet count, and albumin level as surrogate markers for CDAD.
  • To uniquely assess these markers by excluding patients with major hematologic disorders.

Main Methods:

  • Retrospective review of inpatient data.
  • Inclusion criteria: nosocomial diarrhea diagnosis and stool sample testing for C. difficile toxins A and B.
  • Exclusion criteria: patients with major hematologic disorders.

Main Results:

  • Study included 77 C. difficile-positive and 91 C. difficile-negative patients.
  • Patients with CDAD exhibited significantly higher leukocyte and platelet counts compared to controls.
  • Hypoalbuminemia was significantly more prevalent in patients with CDAD.

Conclusions:

  • Leukocytosis, thrombocytosis, and hypoalbuminemia are confirmed as reliable clinical predictors for CDAD.
  • These findings remain valid even after excluding confounding hematologic conditions.
  • The study reinforces the utility of these hematologic markers in diagnosing CDAD.
Abstract

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