PDF(Pubmed)
Abstract：
Background/ Rationale Clostridioides difficile infection (CDI) is transmitted via the fecal-oral route and is implicated in antibiotic-associated colitis. Similar to CDI, patients with coronavirus disease 2019 (COVID-19) require early identification and isolation, appropriate personal protective equipment, and environmental disinfection to prevent further transmission. In light of this similarity between isolation and protective requirements to prevent transmission of these diseases, we aim to investigate whether there was a decrease in the incidence of CDI during the peak periods of the COVID-19 pandemic compared to historical rates. Methods This is a single-center retrospective analysis of the rates of CDI in our institution. COVID-19 time periods were identified from March 2020 to January 2021 and peak periods (with >50 active patients per day) were defined. The non-COVID-19 periods were July 2017 to February 2020. Rates of CDI were also directly compared across the yearly time period. CDI rates were presented in a per 1000 patient days format. Rates were analyzed per year and during the COVID-19 peaks at our institution. Mann-Whitney U test was used to compare rates between two time periods, while differences across multiple time intervals were analyzed using the Kruskal-Wallis test. Results The median (interquartile range [IQR]) of CDI rates of infection per 1000 patient days for the non-COVID time period from July 2017 to February 2020 was 0.34 (0.23-0.45) while COVID time periods had higher 0.44 (0.25-0.51) rates of CDI although this was not statistically significant (p=0.224). However, there was a statistically significant difference (p=0.036) with COVID peak periods having higher rates of CDI 0.49(0.39-0.74) vs 0.34(0.23-0.44). Overall, there was no statistically significant difference in the rates of CDI across years or time periods (p=0.396). Discussion/Conclusion There was no difference in the rates of hospital-acquired CDI between COVID-19 and non-COVID-19 time periods at our institution.
摘要：
背景/原理艰难梭菌感染（CDI）通过粪-口途径传播，并与抗生素相关性结肠炎有关。类似于CDI,2019年冠状病毒病（COVID-19）患者需要早期识别和隔离，适当的个人防护设备，和环境消毒，以防止进一步传播。鉴于隔离和防止这些疾病传播的保护要求之间的相似性，我们的目的是调查与历史发病率相比,在COVID-19大流行高峰期CDI的发病率是否有所下降.方法单中心回顾性分析我院CDI发生率。从2020年3月至2021年1月确定了COVID-19时间段，并定义了高峰期（每天>50名活跃患者）。非COVID-19期间为2017年7月至2020年2月。CDI的比率也在整个年度期间进行了直接比较。CDI率以每1000个患者日的格式呈现。每年和在我们机构的COVID-19高峰期间对费率进行分析。Mann-WhitneyU检验用于比较两个时间段之间的比率，使用Kruskal-Wallis检验分析了多个时间间隔之间的差异。结果2017年7月至2020年2月，非COVID时间段的CDI感染率中位数（四分位距[IQR]）为0.34（0.23-0.45），而COVID时间段的CDI感染率更高0.44（0.25-0.51），尽管这没有统计学意义（p=0.224）。然而,COVID高峰期CDI0.49（0.39-0.74）比0.34（0.23-0.44）的发生率更高，差异有统计学意义（p=0.036）。总的来说,不同年份或不同时间段的CDI发生率无统计学差异(p=0.396).讨论/结论在我们机构，COVID-19和非COVID-19时间段的医院获得性CDI率没有差异。
