An "accurate, robust and simple" test has been developed by scientists in the UK to identify a patient’s risk of death from Clostridium difficile (C. diff) infection.
The four point test measures different clinical variables which can be used to accurately predict the death risk to patients from C. diff.
C. diff can affect the digestive system and most commonly affects people staying in hospital.
In 2011 there were 17,414 reported cases in England and C. diff related deaths accounted for 1.1% of all deaths in England and Wales between 2006 and 2010.
The infection mostly affects people aged 65 and over.
The research was conducted by University of Exeter and the Royal Devon and Exeter (RD&E) NHS Foundation Trust, with the National Institute for Health Research in the South West, and is detailed in a paper published by BMC Infectious Diseases.
To develop the test, scientists analysed the clinical notes of 213 patients who had been transferred to the RD&E’s specialised C. diff ward between 2007 and 2009.
This, and other information collected, helped them establish the four points of the test, which are: serum albumin levels (protein in blood plasma); respiratory rate; C-reactive protein (a protein found in blood, the levels of which rise in inflammation); and white cell count.
A simple four variable prediction rule was then devised based on acceptable thresholds for the results of each test.
"The clinical variables identified are easily measurable, using tests that are commonly carried out in hospital," said senior lecturer in molecular microbiology at the University of Exeter Dr Steve Michell.
"The results of our study strengthen the evidence for establishing the use of this rule in clinical settings: the benefits to patient well-being, the efficient management of infection in hospital and potential savings to the NHS and other health services around the world, would be immense."
The four point test can be carried out by non-specialists assessing patients within or around 48 hours of diagnosis.
Consultant physician at the RD&E, Dr Ray Sheridan, said because patients with C. diff don’t always have outward signs of infection, such as a high temperature, they are often sicker than they look.
"This makes it difficult for non-specialists to recognise how ill patients are and when to start the right treatment."
He added: "This really simple and quick tool, which any junior doctor could use in the middle of the night quickly and easily, flags up those who need a speedy and intensive treatment regime or more senior help."
Image: This photograph depicts Clostridium difficile colonies after 48hr growth on a blood agar plate. Photo courtesy of PD-USGov-HHS-CDC.
