Did Clostridioides difficile testing and infection rates change during the COVID-19 pandemic?

Hawes, Armani M.; Desai, Angel N.; Patel, Payal

doi:10.1016/j.anaerobe.2021.102384

Cited by 24 publications

(23 citation statements)

References 7 publications

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“…Data on the incidence of HA-CDI in COVID-19 patients is still scarce and disparate ( 5 – 8 , 14 , 17 – 21 ) several studies describe a lower incidence of CDI during the pandemic ( 5 – 8 ). As summarized by Granata et al, most studies find a lower or equal incidence of CDI in the first phase of the pandemic than in the pre-pandemic period ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Clostridioides difficile infection epidemiology and clinical characteristics in COVID-19 pandemic

Vázquez-Cuesta

Olmedo²,

Reigadas³

et al. 2022

Front. Med.

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Information on Clostridioides difficile infection (CDI) in patients with COVID-19 is scarce and points to an overall decrease of episodes during the pandemic. This situation results paradoxical, as COVID-19 patients had long periods of hospital stay and high use of antibiotics. We conducted a retrospective study from January 1st 2019 to December 31st 2020 comparing the incidence of hospital-acquired episodes of CDI (HA-CDI) among patients with and without COVID-19 admitted to our institution. During the study period, there were 47,048 patient admissions in 2019, 35,662 admissions of patients without COVID-19 in 2020 and 6,763 of COVID-19 patients. There were 68 episodes of HA-CDI in COVID-19 patients (14.75/10,000 days), 159 in 2020-non-COVID-19 patients (5.54/10,000 days) and 238 in 2019 (6.80/10,000 days). Comparison of HA-CDI in COVID-19 and non-COVID-19 patients indicates it occurs more frequently, in terms of CDI disease severity, COVID-19 does not seem to have a negative impact.

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Section: Discussionmentioning

confidence: 99%

Clostridioides difficile infection epidemiology and clinical characteristics in COVID-19 pandemic

Vázquez-Cuesta

Olmedo²,

Reigadas³

et al. 2022

Front. Med.

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“…A consequence of increased antibiotics prescription in COVID-19 is gut dysbiosis, that creates a favorable environment for C. difficile . However, Hawes et al reported a stable incidence of CDI during the first peak of the pandemic, despite increasing clindamycin, cefotaxime, ceftriaxone, ceftazidime, and quinolone consumption [ 46 ]. Similarly, other authors reported a decreased incidence of CDI that proved the positive effect of intensified cleaning measures together with reduced patient mobility [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Clostridioides Difficile Infection in Hospitalized Patients: What Changed during the Pandemic?

et al. 2022

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(1) Background: Clostridioides difficile (C. difficile) and SARS-CoV-2 coronavirus represent significant health threats. Our study focused on the impact of concurrent infections on patient outcomes against the backdrop of changes imposed by the pandemic. (2) Materials and methods. We performed a retrospective analysis and included patients diagnosed with CDI who were admitted in our hospital before and during the pandemic. We compared patient exposure to risk factors for CDI in both groups and patient negative outcomes: need for ICU care, prolonged hospitalization, organ failure, toxic megacolon, and death. (3) Results. Overall, 188 patients were included, of which 100 had CDI (the pre-pandemic group), and 88 patients presented both CDI and COVID-19 (the pandemic group). Patients in the pandemic group were significantly older, with a higher Charlson Comorbidity Index (CCI) and a greater exposure to antibiotics and corticosteroids, and were more likely to develop organ dysfunction, to require ICU care and have prolonged hospitalization. The severity of COVID-19, leukocytosis and increased D-dimer levels were indicators of poor prognosis in the pandemic group. Higher CCI scores and leukocytosis increased the risk for negative outcomes in CDI alone patients. (4) Conclusions. The study highlights the negative impact of associated infections on patient outcome. The severity of COVID-19 directly influences the prognosis of patients with concurrent infections

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“…A recent study conducted in nine hospitals in Massachusetts reports that about 40% of patients with COVID‐19 have experienced diarrhea after admission and that two of these patients, critically ill, died prior to receiving a correct therapy for CDI [ 50 ] ( Table 1 ). Some single-center studies have reported a trend toward decreased C. difficile testing and a stable or decreased CDI incidence [ 51 , 52 ] ( Table 1 ). These results could be partially explained with a potential over- or inappropriate testing in the pre-COVID-19 period or more thoughtful testing during the current pandemic.…”

Section: And the Covid-19 Pandemicmentioning

confidence: 99%

“…The underdiagnosis of CDI has already been recognized as an alarming issue in the pre-pandemic period, with about 40 000 inpatients with this infection potentially undiagnosed in European hospitals every year due to the absence of clinical suspicion and/or suboptimal diagnostic laboratories in the pre-pandemic period [ 71 ]. Recent studies have reported a trend toward decreased C. difficile testing in several hospitals [ 47 , 49 , 51 , 52 ] ( Table 1 ), suggesting that the COVID‐19 pandemic may lead to a further underreporting of CDI and highlighting the importance of a differential diagnosis of CDI in patients with COVID-19.…”

Section: What About CDI In the Next Future?mentioning

confidence: 99%

Clostridioides difficile infection (CDI) during the COVID-19 pandemic

Spigaglia

2022

Anaerobe

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The ongoing coronavirus disease (COVID-19) pandemic has dramatically tested healthcare systems around the world, with serious repercussions on the measures of prevention and control of hospital-acquired infections (HAIs). Among HAIs, Clostridioides difficile infection (CDI) represents one of the most important global public health threats. Although the full impact of the COVID-19 pandemic on CDI remains undetermined, depending on the development of the pandemic in the coming months, in this review literature studies of the last three years have been considered in order to depict the current situation, and make some considerations about possible future developments. If on the one hand, a general reduction in CDI incidence has been reported in several settings, mainly due to the extraordinary reinforcement of infection prevention measures, on the other hand, the critical circumstances experienced in many hospitals have limited the effectiveness of these measures, particularly in the intensive care units (ICUs), increasing the possibility of the occurrence of hospital-acquired CDI (HA-CDI). New concerns have arisen from the decrease in C. difficile testing and the increased use of broad-spectrum antibiotics reported during the pandemic. In particular, overuse of antibiotics and disinfectants may lead to a selection of resistant C. difficile strains not only in hospitals but also in the community. Furthermore, patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and patients that have survived COVID-19 may represent a new group of frail patients potentially at a higher risk of CDI, a group that could potentially increase in size due to SARS-CoV-2 evolution. In the dramatic COVID-19 era, the multifactorial nature of CDI has emerged more clearly than before, highlighting the necessity of a strong refocus on efforts to improve prevention strategies and to integrate CDI surveillance in a One Health prospective in order to curtail the public health threat posed by this infection in the next future.

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Did Clostridioides difficile testing and infection rates change during the COVID-19 pandemic?

Cited by 24 publications

References 7 publications

Clostridioides difficile infection epidemiology and clinical characteristics in COVID-19 pandemic

Clostridioides difficile infection epidemiology and clinical characteristics in COVID-19 pandemic

The Impact of Clostridioides Difficile Infection in Hospitalized Patients: What Changed during the Pandemic?

Clostridioides difficile infection (CDI) during the COVID-19 pandemic

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