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Updated: May 18, 2026

Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
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Published on: December 10, 2016

Clostridium difficile ribotype does not predict severe infection.

Seth T Walk1, Dejan Micic, Ruchika Jain

  • 1Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|September 14, 2012
PubMed
Summary
This summary is machine-generated.

Clostridium difficile ribotypes 027 and 078 do not predict severe disease. White blood cell count and albumin levels are key indicators for severe Clostridium difficile infection (CDI).

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Previous studies suggested specific Clostridium difficile ribotypes, such as 027 and 078, correlate with increased disease severity.
  • However, emerging evidence questions the validity of this hypothesis, necessitating further investigation.

Purpose of the Study:

  • To investigate whether Clostridium difficile ribotype is an independent predictor of clinical severity in Clostridium difficile infection (CDI).
  • To identify other key predictors of severe CDI when adjusted for ribotype and other covariates.

Main Methods:

  • A cross-sectional study involving toxigenic C. difficile isolates from stool samples.
  • Polymerase chain reaction (PCR) was used for virulence factor screening and fluorescent PCR ribotyping.
  • Data on 15 covariates were collected and analyzed for their influence on the association between ribotype and severe CDI, with validation on an independent dataset.

Main Results:

  • Out of 310 CDI cases, 34 (11.0%) were classified as severe.
  • While 11 covariates, including ribotype, were significant in unadjusted analysis, ribotypes 027 and 078 were not significant predictors after adjustment.
  • In fully adjusted models, only white blood cell count and albumin level significantly predicted severe CDI, a finding consistent in a validation dataset of 433 cases.

Conclusions:

  • Clostridium difficile ribotype is not a significant predictor of severe CDI when accounting for other clinical and microbiological variables.
  • Patient's white blood cell count and albumin level are the most clinically relevant predictors for identifying severe CDI cases.