Prediction of recurrent clostridium difficile infection at the bedside: the GEIH-CDI score

Recommendations for the diagnosis and treatment of Clostridioides difficile infection: An official clinical practice guideline of the Spanish Society of Chemotherapy (SEQ), Spaish Society of Internal Medicine (SEMI) and the working group of Postoperative Infection of the Spanish Society of Anesthesia and Reanimation (SEDAR)

“…As the microorganism is concern, it seems clear that strains with high toxin production, as is the case with many of those grouped as 027, are associated with an increased risk of recurrence [186][187][188][189]. Despite all these data, risk scores for predicting recurrences, based on the association of clinical signs or symptoms, have not functioned adequately on most studies [190][191][192][193][194][195][196] and only in some works are they attributed a certain orientative value [197,198]. Some authors have used also toxin production, through what we might consider a surrogate marker, that would be the amplification cycle of PCR curves.…”

“…In this most-at-risk population, the reduction in recurrent episodes after receiving bezlotoxumab was 53%. However, not all risk factors are equally predictive [193,194,198,204] and none of these models or scores seem to have been widely accepted.…”

Assessment of urinary 3-indoxyl sulfate as a marker for gut microbiota diversity and abundance of Clostridiales

“…While our study did therefore not confirm urinary 3-IS as an effective independent predictor for development of CDI, it showed that it may still be of value within the context of a risk assessment score. Such a score has already been validated for prediction of CDI outcome and recurrence [10][11][12][13] , but not for prediction of disease onset. In a first step, the data from this pilot study could be used to design a large prospective cohort study in which established clinical risk factors for CDI (e.g.…”

Infección por Clostridioides difficile: ¿Debemos cambiar nuestro enfrentamiento en el diagnóstico y tratamiento?

“…Las guías IDSA recomiendan que si se encuentra disponible, vancomicina debería ser la elección 2 . Dado que existen dos estudios que demuestran que en ICD moderada a grave, vancomicina es superior a metronidazol, nosotros sugerimos que vancomicina debería ser usado en estos dos escenarios, o en aquellos pacientes con cuadros leves que tengan factores asociados a mayor riesgo de recurrencia (mayores de 65 años, historia de ICD previa, entre otros) [3][4][5] . En segundo lugar, ante un primer episodio de recurrencia, las Guías IDSA recomiendan usar vancomicina si se utilizó metronidazol previamente, o vancomicina en esquema en pulsos o descenso progresivo si este antibacteriano fue utilizado en el primer episodio.…”