Older age , use of antibiotics after diagnosis , use of proton pump inhibitors , and strain type were the most frequent risk factors for recurrence .
Older age , leucocytosis , renal failure and co-morbidities were frequent risk factors for complicated CDI .
When considered alone , mortality was associated with age , co-morbidities , hypo-albuminemia , leucocytosis , acute renal failure , and infection with ribotype 027 .
BACKGROUND Clostridium difficile infection ( CDI ) can lead to complications , recurrence , and death .
Numerous studies have assessed risk factors for these unfavourable outcomes , but systematic review s or meta-analyses published so far were limited in scope or in quality .
Clinical and laboratory evaluation of a real-time PCR for Clostridium difficile toxin A and B genes
Many laboratories use enzyme immunoassays ( EIAs ) for the diagnosis of Clostridium difficile infection ( CDI ) . More recently , polymerase chain reaction (PCR)-based diagnosis has been described as a sensitive test . Real-time PCR for the detection of C. difficile toxin A and B genes was evaluated . A prospect i ve evaluation was performed on stool sample s from 150 hospitalized adult patients and 141 healthy volunteers .  PCR was compared to toxigenic culture ( TC ) , direct cytotoxicity test ( CTT ) , ImmunoCard ® Toxin A and B ( Meridian Bioscience ) , and enzyme-linked immunosorbent assay ( ELISA ) ( Vidas ) . The results were correlated with clinical data using a st and ardized question naire . The diagnostic yield of the PCR was further evaluated after implementation . Using toxigenic culture as the gold st and ard , the sensitivity and specificity of PCR were 100 and 99.2 % , respectively . Patients were categorized as follows : TC/PCR-positive ( n = 17 ) and negative TC ( n = 133 ) . The differences in these groups were more frequent use of antibiotics and leukocytosis ( p < 0.05 ) . The diagnostic yield of PCR  was evaluated during a period of 6 months and showed an increase of positive patients by 50 % . PCR for the detection of toxigenic C. difficile has a high sensitivity and can rule out CDI , but can not differentiate CDI from asymptomatic carriage . Clinicians should be aware of this in order to prevent inappropriate treatment and delay of other diagnostics
Older age , use of antibiotics after diagnosis , use of proton pump inhibitors , and strain type were the most frequent risk factors for recurrence .
Older age , leucocytosis , renal failure and co-morbidities were frequent risk factors for complicated CDI .
When considered alone , mortality was associated with age , co-morbidities , hypo-albuminemia , leucocytosis , acute renal failure , and infection with ribotype 027 .
BACKGROUND Clostridium difficile infection ( CDI ) can lead to complications , recurrence , and death .
Numerous studies have assessed risk factors for these unfavourable outcomes , but systematic review s or meta-analyses published so far were limited in scope or in quality .