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Updated: May 16, 2026
A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
Lymphopenia as a novel marker of Clostridium difficile infection recurrence
Valéry Lavergne1, Yannick Beauséjour, Gilbert Pichette
1Département de Microbiologie Médicale et Infectiologie, Hôpital du Sacré-Coeur de Montréal, 5400, boulevard Gouin Ouest, Montréal, Québec H4J 1C5, Canada. valerylavergne@gmail.com
Background:
Treatment of Clostridium difficile infection (CDI) is often limited by recurrence in 25% of cases. The objective of this study was to determine risk factors of CDI recurrence during a provincial endemic.
Methods:
Data was prospectively collected for 1 year in a Montréal hospital. Inclusion criteria were: age ≥ 18 years; admission for ≥ 72 h; CDI diagnosis during current admission; no CDI diagnosis in the previous 3 months.
Results:
A total of 121 patients were included, of which 42% were female. Mean age was 77 years, with a median Charlson comorbidity index of 5. Forty patients (33%) had recurrent disease within 2 months of initial CDI treatment. There were 20 deaths (17%) within the 2-month follow-up period. Higher risk of CDI recurrence was independently associated with older age (HR=2.26 for each decade), female gender (HR=1.56), and lymphopenia at completion of CDI treatment (HR=2.18), while a positive C. difficile antitoxin serology was protective (HR=0.17). CDI recurrence was not associated with either lymphopenia at time of diagnosis, underlying comorbidities, severity or treatment of the initial CDI episode, or re-exposure to antibiotics during the follow-up period.
Conclusion:
Lymphopenia at the end of CDI treatment appears to be a strong marker for CDI recurrence. This available and inexpensive test may identify patients who are at higher risk of CDI recurrence.
