Predicting Severe CDI in High-Risk Adults

Clostridioides difficile infection (CDI) is a leading cause of healthcare-associated diarrhea, with high morbidity and mortality. Immunocompromised adults; such as those receiving chemotherapy, hematopoietic stem cell or solid organ transplants, or long-term immunosuppressive therapy; are at heightened risk for severe or recurrent CDI due to altered immunity, dysregulated gut microbiota, and frequent healthcare exposures. Existing risk prediction models are limited, often derived from general hospital populations, and rarely account for immunocompromised-specific risk factors.

This research project aims to develop and internally validate two independent multivariable risk prediction models for severe and recurrent CDI in immunocompromised adults. Secondary objectives include identifying clinical, laboratory, and treatment-related predictors and evaluating model performance in relevant subgroups.

These models will enable early identification of immunocompromised patients at high risk of severe or recurrent CDI, supporting targeted surveillance, prophylaxis, and individualized treatment strategies. Ultimately, this research aims to improve outcomes, optimize resource use, and contribute to precision infectious disease management in high-risk populations.