Clinical Determinants Predicting Clostridioides difficile Infection among Patients with Chronic Kidney Disease

Area of Science:

• Nephrology
• Infectious Diseases
• Clinical Medicine

Background:

• Clostridioides difficile infection (CDI) presents a significant threat to patients with chronic kidney disease (CKD).
• Existing research highlights increased incidence and mortality of CDI in CKD populations.

Purpose of the Study:

• To identify clinical factors predicting CDI development in hospitalized CKD patients.
• To inform and enhance prevention strategies for CDI in this vulnerable group.

Main Methods:

• Retrospective analysis of medical records for 279 hospitalized CKD patients with suspected CDI.
• Identification of 93 patients who tested positive for CDI.

Main Results:

• Factors associated with higher CDI incidence included older age, poorer kidney function, high Padua Prediction Score (PPS), and extended antibiotic treatment duration.
• Lower Body Mass Index (BMI), reduced scores on the Norton Abrasive Scale (ANSS), and decreased serum albumin levels were observed in CDI patients.
• Multivariate analysis confirmed advanced CKD stage and antibiotic duration as risk factors, while higher serum albumin and ANSS scores demonstrated a protective effect.

Conclusions:

• Clinical determinants such as advanced CKD stage and prolonged antibiotic exposure significantly elevate CDI risk.
• Maintaining adequate serum albumin levels and utilizing the Norton scale can aid in preventing CDI among CKD patients.