Association of decreased serum protein fractions with Clostridium difficile infection in the acute care setting: a case-control study.
OBJECTIVE
This study examines the association of decreased levels of serum proteins with the occurrence of Clostridium difficile-associated diarrhea (CDAD) in hospitalized patients.


METHODS
This is a retrospective case-control study using a case cohort (n = 171) that had been described in an earlier study and a cohort of 332 contemporaneous controls.


RESULTS
Patients with CDAD had significantly lower serum levels of albumin, total protein and globulins, and decreased albumin/globulin ratio (p < 0.0001 for all parameters). After adjustment for confounders, hypoproteinemia was more closely associated with CDAD than either hypoalbuminemia or albumin/globulin ratio. Hypoproteinemia exhibited an odds ratios of 10.6 (95% CI: 6.62-17.0) after adjustment for race, and 11.0 (95% CI: 6.88-17.1) after adjustment for age.


CONCLUSIONS
Decreased total serum protein is more closely associated with CDAD than hypoalbuminemia.
Department of Medicine, St Joseph's Regional Medical Center, Paterson, NJ, USA.
Raquel
R
Salazar-Kagunye
Anish
A
Shah
Gina
G
Loshkajian
Walid
W
Baddoura
Vincent A
VA
DeBari
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016360:Clostridioides difficile / Q000502:physiology*; D004761:Enterocolitis, Pseudomembranous / Q000097:blood* / Q000628:therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D005791:Patient Care; D012372:ROC Curve; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D012712:Serum Globulins / Q000378:metabolism*
D012709:Serum Albumin; D012712:Serum Globulins