Elevated White Blood Cell Count Does Not Predict Clostridium difficile Nucleic Acid Testing Results
| Autor: | Niklas Krumm, Patrick C. Mathias, Ferric C. Fang, Dustin E Bosch, Alexander L. Greninger, Andrew Bryan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty 030106 microbiology Bacterial Toxins Gastroenterology 03 medical and health sciences Leukocyte Count 0302 clinical medicine Internal medicine Nucleic Acids medicine Humans 030212 general & internal medicine Leukocytosis Elevated white blood cell count Feces Retrospective Studies business.industry Clostridioides difficile Emergency department Clostridium difficile Confidence interval Metronidazole Infectious Diseases Clostridium Infections Vancomycin medicine.symptom business medicine.drug |
| Zdroj: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 73(4) |
| ISSN: | 1537-6591 |
| Popis: | Background An elevated white blood cell count (WBC; >15 000/μL) is an established prognostic marker in patients with Clostridium difficile infection (CDI). Small observational studies have suggested that a markedly elevated WBC should prompt consideration of CDI. However, there is limited evidence correlating WBC elevation with the results of C. difficile nucleic acid amplification testing (NAAT). Methods Retrospective review of laboratory testing, outcomes, and treatment of 16 568 consecutive patients presenting to 4 hospitals over 4 years with NAAT and WBC testing on the same day. Results No significant relationship between C. difficile NAAT results and concurrent WBC in the inpatient setting was observed. Although an elevated WBC did predict NAAT results in the outpatient and emergency department populations (P 15 000/μL) in CDI was associated with a longer median hospital length of stay (15.5 vs 11.0 days; P Conclusions Although WBC is an important prognostic indicator in patients with CDI, an isolated WBC elevation has low sensitivity and specificity as a predictor of fecal C. difficile NAAT positivity in the inpatient setting. A high or rising WBC in isolation is not a sufficient indication for CDI testing. |
| Databáze: | OpenAIRE |
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