Detection and risk factor analysis of Clostridioides difficile infection in patients with malignant tumours

To identify risk factors for Clostridioides difficile infection (CDI) in patients with malignant tumours and establish a predictive model for clinical prevention and early intervention.

This retrospective study included 92 patients with malignant tumours (46 CDI-positive, 46 CDI-negative) admitted to our hospital. Demographic characteristics, clinical parameters, laboratory indicators and treatment factors were collected and analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for CDI, and a predictive model was established and evaluated using receiver operating characteristic curve analysis.

Patients with CDI had significantly lower serum albumin levels (30.12 ± 5.86 vs 34.15 ± 7.88 g/L, P = 0.007) and higher C-reactive protein (CRP) levels (89.38 ± 91.01 vs 49.17 ± 51.78 mg/L, P = 0.011) than patients without CDI. The CDI-positive group had significantly higher rates of multiple antibiotic use (52.2 % vs 10.9 %, P < 0.001) and corticosteroid/immunosuppressant use (58.7 % vs 30.4 %, P = 0.007) than the CDI-negative group. Multivariate logistic regression analysis identified four independent risk factors for CDI: multiple antibiotic use (odds ratio [OR] = 7.56, 95 % confidence interval [CI]: 2.41-23.73, P < 0.001), corticosteroid/immunosuppressant use (OR = 2.81, 95 % CI: 1.08-7.32, P = 0.035), serum albumin (per g/L increase: OR = 0.94, 95 % CI: 0.88-1.00, P = 0.049) and CRP (per mg/L increase: OR = 1.01, 95 % CI: 1.00-1.01, P = 0.047). The multivariate predictive model demonstrated excellent discriminative ability (area under the curve = 0.907).

Multiple antibiotic use, corticosteroid/immunosuppressant therapy, hypoalbuminaemia and elevated CRP are independent risk factors for CDI in patients with malignant tumours. The predictive model established in this study may help identify patients at high risk who could benefit from preventive interventions.