Infection Probability Score: a predictor of Clostridium difficile-associated disease onset in patients with haematological malignancy.
OBJECTIVE
to assess the predictive power of three systems: Infection Probability Score, APACHE II and KARNOFSKY score for the onset of Clostridium difficile-associated disease (CDAD) in hematology-oncology patients.


METHODS
A retrospective pilot surveillance survey was conducted in the hematology unit of a general hospital in Greece. Data were collected by using an anonymous standardised case-record form. The sample consisted of 102 hospitalized patients.


RESULTS
The majority of the patients (33.3%) suffered from acute myeloid leukemia. The cumulative incidence of CDAD was 10.8% and the incidence rate of C difficile associated diarrhea was 5 per 1000 patient-days (14.2 per 1000 patient-days at risk). Patients with CDAD had twofold higher time of mean length of hospital stay compared with patients without CDAD (38.82 ± 23.88 vs 19.45 ± 14.56 days). Additionally patients with CDAD had received a greater number of different antibiotics compared to those without CDAD (5.18 ± 1.99 vs 2.54 ± 2.13), suffered from diabetes, from non Hodgkin's lymphoma, had a statistically significant higher duration of neutropenia ≥3 days and had received antifungal treatment. The best cutoff value of IPS for the prediction of CDAD was 13 with a sensitivity of 45.5% and a specificity of 82.4%.


CONCLUSIONS
IPS is an early diagnostic test for CDAD detection.
University of Athens, Nursing Department, Athens, Greece.
Eleni
E
Apostolopoulou
Vasilios
V
Raftopoulos
Konstantinos
K
Terzis
Ioannis
I
Elefsiniotis
D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile; D003428:Cross Infection / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006115:Greece / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D015994:Incidence; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011159:Population Surveillance / Q000379:methods*; D011237:Predictive Value of Tests; D011336:Probability; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult