Trends in <i>Clostridioides difficile</i> infection rates in Canadian hospitals during the coronavirus disease 2019 (COVID-19) pandemic

Choi, Kelly Baekyung; Du, Tim; Silva, Anada; Golding, George R.; Pelude, Linda; Mitchell, Richard; Rudnick, Wallis; Hizon, Romeo; Al‐Rawahi, Ghada N.; Chow, Blanda; Davis, Ian; Evans, Gerald A.; Frenette, Charles; Johnstone, Jennie; Kibsey, Pamela; Katz, Kevin; Langley, Joanne M.; Lee, Bonita E.; Longtin, Yves; Mertz, Dominik; Minion, Jessica; Science, Michelle; Srigley, Jocelyn A.; Stagg, Paula; Suh, Kathryn N.; Thampi, Nisha; Wong, Alice; Comeau, Jeannette; Hota, Susy

doi:10.1017/ice.2022.210

Cited by 11 publications

(14 citation statements)

References 15 publications

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Section: Discussionmentioning

confidence: 97%

“…On the other hand, multiple other studies showed an increase in CDI rates [ 2 , 3 , 7 ]. A recent large Canadian study involving multiple centers revealed an 11% increase in hospital-acquired CDI during the pandemic [ 8 ]. Another retrospective analysis, investigating the COVID-19 era until January 2021, identified higher CDI rates during COVID-19 peak periods [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Even though multiple analyses identified lower CDI rates during the pandemic, mainly attributed to the infection prevention protocols implemented during the pandemic, there were others that found an increase in CDI cases [2][3][4][6][7][8]. Plausible explanations for this increase may be the increased use of antibiotics and/or steroid or even the inpatient population profile change during the pandemic [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Clostridium difficile Infection Rates During the Pandemic in New York Capital Area: A Single-Center Study

Zouridis¹,

Sangha²,

Feustel³

et al. 2023

Cureus

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IntroductionClostridioides difficile (C. difficile) colonizes the large intestine, rendering healthy individuals asymptomatic carriers of the disease. In certain instances, C. difficile infection (CDI) occurs. Antibiotic use remains the leading risk factor for CDI. During the coronavirus disease 2019 (COVID-19) pandemic, multiple risk and protective factors for and against CDI were identified, and as such multiple studies tried to analyze the pandemic's overall effect on CDI incidence rates, with contradictory results. Our study's aim is to further characterize the CDI incidence rates trends, but for a longer period of 22 months in the pandemic. MethodsWe included only adult (>18 years) patients, diagnosed with CDI during their hospitalization for the following period

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clostridium difficile Infection Rates During the Pandemic in New York Capital Area: A Single-Center Study

Zouridis¹,

Sangha²,

Feustel³

et al. 2023

Cureus

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“…HA-CDI rates did not change in the US hospitals [ 23 ] or even decreased in some EU countries [ 24 , 25 ]. In contrast, the incidence rates of HA-CDIs increased in hospitals participating in the Canadian Nosocomial Infection Surveillance Program [ 26 ], after a period of steady decline before the pandemic. This can be explained by altered or even weakened infection prevention and control practices due to pandemic surge pressures and increased antibiotic use.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Clostridioides difficile Infections in Non-COVID and COVID-19 Patients: Experience from a Tertiary Care Hospital

et al. 2023

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(1) Background: The aim of this study was to assess the incidence and the risk factors for healthcare-associated Clostridioides difficile infection (HA-CDI) in patients with COVID-19 and without this infection. (2) Methods: A single-center, prospective observational study was conducted at the University Clinical Hospital Center in Belgrade, Serbia, from January 2019 to December 2021. The entire hospital was a COVID-dedicated hospital for 12 months during the study period. The incidence density rates and risk factors for HA-CDI in patients with and without COVID-19 are presented. (3) Results: The incidence rates of HA-CDIs were three times higher in patients with COVID-19. The HA-CDI–COVID-patients were younger (69.9 ± 12.6 vs. 72.5 ± 11.6; p = 0.017), admitted from another hospital (20.5% vs. 2.9; p < 0.001), had antimicrobial therapy before CDI (99.1% vs. 91.3%, p < 0.001), received two or more antibiotics (p = 0.030) during a longer period (p = 0.035), received proton pump inhibitors (95.9% vs. 50.0%, p < 0.001) during a longer period (p = 0.012) and steroids (32.8% vs. 20.4%, p < 0.001). During the last month before their current hospitalization, a higher percentage of patients without COVID-19 disease were hospitalized in our hospital (p < 0.001). Independent predictors for HA-CDIs in patients with COVID-19 were admission from another hospital (p = 0.003), the length of antibiotic administration (0.020), and the use of steroids in therapy (p < 0.001). The HA-CDI predictors in the non-COVID patients were older age (p = 0.017), advanced-stage renal failure (p = 0.005), chemotherapy (p = 0.003), and a low albumin level (0.005). (4) Conclusion: Higher incidence rates of HAI-CDIs in COVID-19 patients did not occur due to reduced infection control precautions and hygiene measures but due to antibiotic therapy and therapy with other drugs used during the pandemic.

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“…The burden of CDI was estimated to have decreased by 24% from 2011 to 2017 when correcting for changes in diagnostics between those years [8]. More recently, the impact of the COVID-19 pandemic on CDI prevalence has been a focus for several studies; while some have noted increased [12,13] or stable prevalence/incidence [14,15], most have demonstrated a decline [16][17][18] corresponding with decreased testing and extraordinary reinforcement of infection prevention measures [15,18,19]. Broader, more definitive data from the CDC would be helpful to best answer the impact the COVID-19 pandemic had on CDI incidence.…”

Section: The Changing Epidemiology Of CDImentioning

confidence: 99%

The burden of CDI in the United States: a multifactorial challenge

Feuerstadt

Theriault²,

Tillotson³

2023

BMC Infect Dis

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Clostridioides difficile infection (CDI) affects approximately 500,000 patients annually in the United States, of these around 30,000 will die. CDI carries significant burdens including clinical, social and economic. While healthcare-associated CDI has declined in recent years, community-associated CDI is on the rise. Many patients are also impacted by recurrent C. difficile infections (rCDI); up to 35% of index CDI will recur and of these up to 60% will further recur with multiple recurrences observed. The range of outcomes adversely affected by rCDI is significant and current standard of care does not alter these recurrence rates due to the damaged gut microbiome and subsequent dysbiosis. The clinical landscape of CDI is changing, we discuss the impact of CDI, rCDI, and the wide range of financial, social, and clinical outcomes by which treatments should be evaluated.

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Trends in Clostridioides difficile infection rates in Canadian hospitals during the coronavirus disease 2019 (COVID-19) pandemic

Cited by 11 publications

References 15 publications

Clostridium difficile Infection Rates During the Pandemic in New York Capital Area: A Single-Center Study

Clostridium difficile Infection Rates During the Pandemic in New York Capital Area: A Single-Center Study

Incidence and Risk Factors for Clostridioides difficile Infections in Non-COVID and COVID-19 Patients: Experience from a Tertiary Care Hospital

The burden of CDI in the United States: a multifactorial challenge

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