. 2013 Nov-Dec;66(6):361–368. doi: 10.4212/cjhp.v66i6.1301

Table 1.

Criteria for Severe Clostridium difficile Infection

SHEA-IDSA¹	American College of Gastroenterology²	Zar et al.²³ ^*
WBC^† ≥ 15000 cells/μL OR Serum creatinine ≥ 1.5 × premorbid value	Severe disease: Hypoalbuminemia (< 30 g/L), plus ONE of the following: Abdominal distension Elevated WBC^† (≥ 15 000 cells/mm³) Severe and complicated disease (any ONE of the following): Admission to ICU Hypotension ± vasopressor use Fever (temperature > 38.5°C) Ileus or significant abdominal distension Mental status changes WBC^† ≥ 35 000 cells/mm³ or < 2000 cells/mm³ Serum lactate > 2.2 mmol/L End organ failure	Age > 60 years (1 point) Temperature > 38.3°C (1 point) Albumin < 25 g/L (1 point) WBC^† > 15 000 cells/mm³ (1 point) Endoscopic evidence of pseudomembranous colitis (2 points) Admission to ICU (2 points)

SHEA-IDSA¹

American College of Gastroenterology²

Zar et al.²³ ^*

WBC^† ≥ 15000 cells/μL
OR
Serum creatinine ≥ 1.5 × premorbid value

Severe disease:
Hypoalbuminemia (< 30 g/L), plus ONE of the following:

Abdominal distension
Elevated WBC^† (≥ 15 000 cells/mm³)

Severe and complicated disease (any ONE of the following):

Admission to ICU
Hypotension ± vasopressor use
Fever (temperature > 38.5°C)
Ileus or significant abdominal distension
Mental status changes
WBC^† ≥ 35 000 cells/mm³ or < 2000 cells/mm³
Serum lactate > 2.2 mmol/L
End organ failure

Age > 60 years (1 point)
Temperature > 38.3°C (1 point)
Albumin < 25 g/L (1 point)
WBC^† > 15 000 cells/mm³ (1 point)
Endoscopic evidence of pseudomembranous colitis (2 points)
Admission to ICU (2 points)

ICU = intensive care unit, SHEA-IDSA = Society for Hospital Epidemiology of America and the Infectious Diseases Society of America, WBC = white blood cells.

Severe disease defined as a score of 2 or greater.

^†

WBC counts in conventional units, as presented in the original sources; for conversion to SI unit (× 10⁹/L), multiply count per cubic millilitre or per microlitre by 0.001 (e.g., 15 000 cells/mm³ = 15 × 10⁹/L).