Increase of healthcare-onset Clostridioides difficile infection in adult population since SARS-CoV-2 pandemic: A retrospective cohort study in a tertiary care hospital from 2019 to 2022

IF 2.5 3区生物学 Q3 MICROBIOLOGY Anaerobe Pub Date : 2024-02-28 DOI:10.1016/j.anaerobe.2024.102836

Alfredo Maldonado-Barrueco , Francisco Moreno-Ramos , Beatriz Díaz-Pollán , Belén Loeches-Yagüe , Alicia Rico-Nieto , Julio García-Rodríguez , Guillermo Ruiz-Carrascoso

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Abstract

Objectives

The aim was to assess the impact of the SARS-CoV-2 pandemic on the prevalence, relative incidence (RI), incidence density (ID), ratio of rate incidence (RRI), rate of incidence density (RID), and relative risks (RR) of healthcare-onset Clostridioides difficile infection (HO-CDI) as well as its correlation with the antibiotic consumption.

Methods

Demographic and analytical data of adult patients exhibiting diarrhoea and testing positive for C. difficile were systematically collected from a tertiary care hospital in Madrid (Spain). The periods analysed included: prepandemic (P0), first pandemic-year (P1), and second pandemic-year (P2). We compared global prevalence, RI of HO-CDI per 1,000-admissions, ID of HO-CDI per 10,000-patients-days, RRI, RID, and RR. Antibiotic consumption was obtained by number of defined daily dose per 100 patient-days.

Results

In P0, the prevalence of HO-CDI was 7.4% (IC95%: 6.2–8.7); in P1, it increased to 8.7% (IC95%: 7.4–10.1) (p = 0.2), and in P2, it continued to increase to 9.2% (IC95%: 8–10.6) (p < 0.05). During P1, the RRI was 1.5 and RID was 1.4. However, during P2 there was an increase in RRI to 1.6 and RID to 1.6. The RR also reflected the increase in HO-CDI: at P1, the probability of developing HO-CDI was 1.5 times (IC95%: 1.2–1.9) higher than P0, while at P2, this probability increased to 1.6 times (IC95%: 1.3–2.1). There was an increase in prevalence, RI, ID, RR, RRI, and RID during the two postpandemic periods respect to the prepandemic period. During P2, this increase was greater than the P1. Meropenem showed a statistically significant difference increased consumption (p < 0.05) during the pandemic period. Oral vancomycin HO-CDI treatment showed an increase during the period of study (p > 0.05).

Conclusions

Implementation of infection control measures during the SARS-CoV-2 pandemic did not appear to alleviate the burden of HO-CDI. The escalation in HO-CDI cases did not exhibit a correlation with overall antibiotic consumption, except for meropenem.

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自SARS-CoV-2大流行以来，医护人员感染艰难梭菌的人数增加：2019年至2022年一家三级医院的回顾性队列研究。

研究目的目的：评估 SARS-CoV-2 大流行对医源性艰难梭菌感染（HO-CDI）的流行率、相对发病率 (RI)、发病密度 (ID)、发病率比率 (RRI)、发病密度比率 (RID) 和相对风险 (RR) 的影响及其与抗生素消耗量的相关性：方法：从马德里的一家三级医院系统收集了腹泻且艰难梭菌检测呈阳性的成年患者的人口统计学和分析数据。分析的时期包括：流行前（P0）、第一个流行年（P1）和第二个流行年（P2）。我们比较了全球流行率、每 1000 例入院患者中的 HO-CDI RI、每 10,000 例患者-天中的 HO-CDI ID、RRI、RID 和 RR。抗生素消耗量按每 100 个患者日的规定日剂量计算：结论：在 SARS-CoV-2 大流行期间实施感染控制措施似乎并没有减轻 HO-CDI 的负担。除了美罗培南之外，HO-CDI病例的增加与抗生素总用量没有相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anaerobe 生物-微生物学

CiteScore

5.20

自引率

8.70%

发文量

137

审稿时长

76 days

期刊介绍： Anaerobe is essential reading for those who wish to remain at the forefront of discoveries relating to life processes of strictly anaerobes. The journal is multi-disciplinary, and provides a unique forum for those investigating anaerobic organisms that cause infections in humans and animals, as well as anaerobes that play roles in microbiomes or environmental processes. Anaerobe publishes reviews, mini reviews, original research articles, notes and case reports. Relevant topics fall into the broad categories of anaerobes in human and animal diseases, anaerobes in the microbiome, anaerobes in the environment, diagnosis of anaerobes in clinical microbiology laboratories, molecular biology, genetics, pathogenesis, toxins and antibiotic susceptibility of anaerobic bacteria.