Recurrent Clostridium difficile infections: The importance of the intestinal microbiota

Table 3 Severity of Clostridium difficile (adapted from[1,10,11])

Severity criteria according to American experts	Non severe CDI	White blood cell count < 15 × 109/L and creatinine level < 1.5 × baseline
	Severe CDI	White blood cell count > 15 × 109/L or creatinine level > 1.5 × baseline
	Severe and complicated CDI	Hypotension or shock or ileus or megacolon
Severity criteria according to European experts	Severe CDI	Age > 65 yr or severe comorbidities or intensive care admission or immunodeficiency
		or
		Presence of ≥ 1 of the following criteria:
		Fever ≥ 38.5  °C
		Shivering
		Hemodynamic instability
		Signs of peritonitis
		Signs of ileus
		White blood cell count > 15 × 109/L
		Creatinine level > 1.5 × baseline
		Elevated serum lactate
		Pseudomembranous colitis (colonoscopy)
		Distension of large intestine (computed tomography, CT scan)
		Colonic wall thickening (CT scan)
		Pericolonic fat stranding (CT scan)
		Ascites not explained by other causes

CDI: Clostridium difficile infection; CT: Computed tomography.