title: [Diagnosis of Clostridium difficile diarrhea: in search of a more efficient clinical focus].
abstract: 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.
authors.affiliation: Departamento de Gastroenterología, Unidad Docente Asociada de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica de Chile. alvarezl@med.puc.cl
authors.forename: M
authors.initials: M
authors.lastname: Alvarez
authors.forename: R
authors.initials: R
authors.lastname: González
authors.forename: I
authors.initials: I
authors.lastname: Briceño
authors.forename: C
authors.initials: C
authors.lastname: Cofre
authors.forename: J
authors.initials: J
authors.lastname: Labarca
authors.forename: P
authors.initials: P
authors.lastname: Vial
authors.forename: P
authors.initials: P
authors.lastname: García
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Diagnóstico de diarrea por Clostridium difficile: en busca de un enfoque clínico más eficiente.