Real-time polymerase chain reaction (PCR) cycle threshold and Clostridioides difficile infection outcomes

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Epidemiology

Background:

• Clostridioides difficile infection (CDI) is a significant cause of morbidity and mortality.
• Current diagnostic methods for CDI can be controversial.
• Predicting disease severity, recurrence, and mortality in CDI patients remains a clinical challenge.

Purpose of the Study:

• To evaluate the association between polymerase chain reaction (PCR) cycle threshold (Ct) values and CDI disease severity.
• To assess the correlation of PCR Ct values with 8-week recurrence and 30-day mortality in adult CDI patients.

Main Methods:

• Retrospective cohort study involving adult patients diagnosed with hospital-onset, healthcare facility-associated CDI.
• Chart review and analysis of PCR Ct values, disease severity, recurrence, and mortality data.
• Univariate and multivariable logistic regression models were employed to determine associations.

Main Results:

• Lower PCR Ct values were significantly associated with an increased odds of 30-day mortality (OR 0.83; 95% CI, 0.72-0.96).
• PCR Ct values were not independently associated with CDI severity (OR, 0.99; 95% CI, 0.90-1.09).
• No independent association was found between PCR Ct values and 8-week CDI recurrence (OR, 0.88; 95% CI, 0.77-1.00).

Conclusions:

• PCR Ct values at diagnosis may have limited predictive value for CDI severity and recurrence.
• The utility of PCR Ct values in clinical decision-making for CDI inpatients requires further investigation.
• Larger, prospective studies are recommended to validate these findings across diverse patient populations.