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Related Experiment Video

Updated: Nov 12, 2025

Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
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A Risk Score to Predict Clostridioides difficile Infection.

Laurie Aukes1, Bruce Fireman1, Edwin Lewis1

  • 1Kaiser Permanente Vaccine Study Center, Oakland, California, USA.

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|March 19, 2021
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Summary

This study identified key risk factors for Clostridioides difficile infection (CDI), a common cause of severe diarrhea. The findings aid in predicting CDI risk and identifying populations for vaccine trials.

Keywords:
Clostridioides difficile risk score model

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Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Clinical Risk Prediction

Background:

  • Clostridioides difficile infection (CDI) is a significant cause of severe diarrhea.
  • Identifying risk factors is crucial for prevention and management strategies.

Purpose of the Study:

  • To identify demographic and clinical risk factors for incident Clostridioides difficile infection (CDI).
  • To develop and validate risk scores for predicting future CDI development.

Main Methods:

  • Retrospective analysis of electronic health records for adult members with and without laboratory-confirmed CDI.
  • Logistic regression models were used to identify risk factors and develop predictive risk scores.
  • Two risk score models were evaluated using different Index Dates for Risk Score Assessment (IDRSA).

Main Results:

  • A large cohort study (9986 CDI cases, 2,230,354 controls) identified older age, female sex, white race, and increased healthcare utilization as CDI risk factors.
  • Risk factors included hospitalizations, emergency visits, skilled nursing facility stays, and use of antibiotics and proton pump inhibitors.
  • A risk score model using hospital discharge as IDRSA demonstrated excellent predictive performance (C-statistic 0.848) for CDI within 31-365 days.

Conclusions:

  • The developed risk scores can effectively identify individuals at high risk for CDI.
  • These findings support targeted enrollment for Clostridioides difficile vaccine trials.
  • The risk scores can improve study feasibility by aiding in sample size and completion time estimations.