[Diagnosis of Clostridium difficile diarrhea: in search of a more efficient clinical focus].
BACKGROUND
The clinical parameters for the suspicion of Clostridium difficile infections, namely the use of antimicrobials and diarrhea, have a low predictive value for the diagnosis.


OBJECTIVE
To search other clinical variables and determine a clinical prediction model for (Clostridium difficile diarrhea.


METHODS
All patients to whom a Clostridium difficile study was requested, were prospectively studied during 5 months. Clinical variables of these patients were registered. The diagnosis of Clostridium difficile was done using the cytotoxicity test in fibroblast cultures.


RESULTS
Ninety two patients were analyzed and in 26, the diagnosis of Clostridium difficile was confirmed. A logistic regression model disclosed an age over 60 years old, the presence of mucus in the stools and a temperature over 37.8 degrees C in the previous 24 h, as significant predictors of the infection. The correlation of the model, between the predicted probability and the observed condition, was 81.5%.


CONCLUSIONS
The presence of the clinical variables identified in this study are associated with a high probability of an infection by Clostridium difficile in patients with diarrhea and the recent use of antimicrobials.
Alvarez
M
M
Departamento de Gastroenterología, Unidad Docente Asociada de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica de Chile. alvarezl@med.puc.cl
González
R
R
Briceño
I
I
Cofre
C
C
Labarca
J
J
Vial
P
P
García
P
P
D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D016360:Clostridioides difficile / Q000302:isolation & purification; D003967:Diarrhea / Q000139:chemically induced / Q000188:drug therapy / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000900:Anti-Bacterial Agents
Diagnóstico de diarrea por Clostridium difficile: en busca de un enfoque clínico más eficiente.