Falcone et al identified risk factors for healthcare-associated bloodstream infection in a patient with Clostridium difficile disease. These can help to identify a patient who may benefit from more aggressive management. The authors are from Sapienza University of Rome and Giovanni Addolorata Hospital in Rome.


Patient selection: Clostridium difficile disease


Outcome: healthcare-associated bloodstream infection (BSI)


Pathogens isolated on blood culture:

(1) Candida species

(2) Entererobacteriaceae

(3) Enterococcus

(4) mixed isolates


Risk factors for healthcare-associated bloodstream infection from multivariate analysis:

(1) PCR ribotype 027 (strain of Clostridium diffiicile)

(2) recurrent Clostridium difficile infection

(3) severe Clostridium difficile infection

(4) oral vancomycin dose > 500 mg per day



• Severe CDI was defined as a white blood cell count > 15,000 per µL OR serum creatinine more than 1.5 times the premorbid concentration.


The mortality rate in patients with bloodstream infection was high.


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