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Association of decreased serum protein fractions with Clostridium difficile infection in the acute care setting: a case–control study

    Raquel Salazar-Kagunye

    Department of Medicine, St Joseph’s Regional Medical Center, Paterson, NJ, USA

    ,
    Anish Shah

    Department of Medicine, St Joseph’s Regional Medical Center, Paterson, NJ, USA

    Division of Gastroenterology, St Joseph’s Regional Medical Center, Paterson, NJ, USA

    Gastroenterology Division, School of Health & Medical Sciences, Seton Hall University, South Orange, NJ, USA

    ,
    Gina Loshkajian

    St George’s University School of Medicine, Grenada, West Indies

    ,
    Walid Baddoura

    Department of Medicine, St Joseph’s Regional Medical Center, Paterson, NJ, USA

    Division of Gastroenterology, St Joseph’s Regional Medical Center, Paterson, NJ, USA

    Gastroenterology Division, School of Health & Medical Sciences, Seton Hall University, South Orange, NJ, USA

    &
    Vincent A DeBari

    * Author for correspondence

    Department of Medicine, School of Health & Medical Sciences, Seton Hall University, South Orange, NJ, USA.

    Published Online:https://doi.org/10.2217/bmm.12.52

    Aim: This study examines the association of decreased levels of serum proteins with the occurrence of Clostridium difficile-associated diarrhea (CDAD) in hospitalized patients. Materials & 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. Conclusion: Decreased total serum protein is more closely associated with CDAD than hypoalbuminemia.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

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