Alfredo Maldonado-Barrueco , Francisco Moreno-Ramos , Beatriz Díaz-Pollán , Belén Loeches-Yagüe , Alicia Rico-Nieto , Julio García-Rodríguez , Guillermo Ruiz-Carrascoso
{"title":"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。","authors":"Alfredo Maldonado-Barrueco , Francisco Moreno-Ramos , Beatriz Díaz-Pollán , Belén Loeches-Yagüe , Alicia Rico-Nieto , Julio García-Rodríguez , Guillermo Ruiz-Carrascoso","doi":"10.1016/j.anaerobe.2024.102836","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>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 <em>Clostridioides difficile</em> infection (HO-CDI) as well as its correlation with the antibiotic consumption.</p></div><div><h3>Methods</h3><p>Demographic and analytical data of adult patients exhibiting diarrhoea and testing positive for <em>C. difficile</em> 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.</p></div><div><h3>Results</h3><p>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) (<em>p</em> = 0.2), and in P2, it continued to increase to 9.2% (IC95%: 8–10.6) (<em>p</em> < 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 (<em>p</em> < 0.05) during the pandemic period. Oral vancomycin HO-CDI treatment showed an increase during the period of study (<em>p</em> > 0.05).</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Alfredo Maldonado-Barrueco , Francisco Moreno-Ramos , Beatriz Díaz-Pollán , Belén Loeches-Yagüe , Alicia Rico-Nieto , Julio García-Rodríguez , Guillermo Ruiz-Carrascoso\",\"doi\":\"10.1016/j.anaerobe.2024.102836\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>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 <em>Clostridioides difficile</em> infection (HO-CDI) as well as its correlation with the antibiotic consumption.</p></div><div><h3>Methods</h3><p>Demographic and analytical data of adult patients exhibiting diarrhoea and testing positive for <em>C. difficile</em> 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.</p></div><div><h3>Results</h3><p>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) (<em>p</em> = 0.2), and in P2, it continued to increase to 9.2% (IC95%: 8–10.6) (<em>p</em> < 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 (<em>p</em> < 0.05) during the pandemic period. Oral vancomycin HO-CDI treatment showed an increase during the period of study (<em>p</em> > 0.05).</p></div><div><h3>Conclusions</h3><p>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.</p></div>\",\"PeriodicalId\":2,\"journal\":{\"name\":\"ACS Applied Bio Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2024-02-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Bio Materials\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1075996424000192\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MATERIALS SCIENCE, BIOMATERIALS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"99","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1075996424000192","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
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
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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