tetano
Editor, Senior Moderator
J Clin Med
. 2020 Nov 27;9(12):E3855.
doi: 10.3390/jcm9123855.
The Burden of Clostridioides Difficile Infection during the COVID-19 Pandemic: A Retrospective Case-Control Study in Italian Hospitals (CloVid)
Guido Granata[SUP] 1 [/SUP], Alessandro Bartoloni[SUP] 2 [/SUP], Mauro Codeluppi[SUP] 3 [/SUP], Ilaria Contadini[SUP] 4 [/SUP], Francesco Cristini[SUP] 4 [/SUP], Massimo Fantoni[SUP] 5 [/SUP], Alice Ferraresi[SUP] 6 [/SUP], Chiara Fornabaio[SUP] 6 [/SUP], Sara Grasselli[SUP] 3 [/SUP], Filippo Lagi[SUP] 2 [/SUP], Luca Masucci[SUP] 5 [/SUP], Massimo Puoti[SUP] 7 [/SUP], Alessandro Raimondi[SUP] 7 [/SUP], Eleonora Taddei[SUP] 8 [/SUP], Filippo Fabio Trapani[SUP] 9 [/SUP], Pierluigi Viale[SUP] 9 [/SUP], Stuart Johnson[SUP] 10 [/SUP], Nicola Petrosillo[SUP] 1 [/SUP], On Behalf Of The CloVid Study Group
Affiliations
Abstract
Data on the burden of Clostridioides difficile infection (CDI) in Coronavirus Disease 2019 (COVID-19) patients are scant. We conducted an observational, retrospective, multicenter, 1:3 case (COVID-19 patients with CDI)-control (COVID-19 patients without CDI) study in Italy to assess incidence and outcomes, and to identify risk factors for CDI in COVID-19 patients. From February through July 2020, 8402 COVID-19 patients were admitted to eight Italian hospitals; 38 CDI cases were identified, including 32 hospital-onset-CDI (HO-CDI) and 6 community-onset, healthcare-associated-CDI (CO-HCA-CDI). HO-CDI incidence was 4.4 ? 10,000 patient-days. The percentage of cases recovering without complications at discharge (i.e., pressure ulcers, chronic heart decompensation) was lower than among controls (p = 0.01); in-hospital stays was longer among cases, 35.0 versus 19.4 days (p = 0.0007). The presence of a previous hospitalisation (p = 0.001), previous steroid administration (p = 0.008) and the administration of antibiotics during the stay (p = 0.004) were risk factors associated with CDI. In conclusions, CDI complicates COVID-19, mainly in patients with co-morbidities and previous healthcare exposures. Its association with antibiotic usage and hospital acquired bacterial infections should lead to strengthen antimicrobial stewardship programmes and infection prevention and control activities.
Keywords: Clostridioides difficile infection; case-control study; coronavirus disease 2019 pandemic; hospital-onset; risk factors.
. 2020 Nov 27;9(12):E3855.
doi: 10.3390/jcm9123855.
The Burden of Clostridioides Difficile Infection during the COVID-19 Pandemic: A Retrospective Case-Control Study in Italian Hospitals (CloVid)
Guido Granata[SUP] 1 [/SUP], Alessandro Bartoloni[SUP] 2 [/SUP], Mauro Codeluppi[SUP] 3 [/SUP], Ilaria Contadini[SUP] 4 [/SUP], Francesco Cristini[SUP] 4 [/SUP], Massimo Fantoni[SUP] 5 [/SUP], Alice Ferraresi[SUP] 6 [/SUP], Chiara Fornabaio[SUP] 6 [/SUP], Sara Grasselli[SUP] 3 [/SUP], Filippo Lagi[SUP] 2 [/SUP], Luca Masucci[SUP] 5 [/SUP], Massimo Puoti[SUP] 7 [/SUP], Alessandro Raimondi[SUP] 7 [/SUP], Eleonora Taddei[SUP] 8 [/SUP], Filippo Fabio Trapani[SUP] 9 [/SUP], Pierluigi Viale[SUP] 9 [/SUP], Stuart Johnson[SUP] 10 [/SUP], Nicola Petrosillo[SUP] 1 [/SUP], On Behalf Of The CloVid Study Group
Affiliations
- PMID: 33260943
- DOI: 10.3390/jcm9123855
Abstract
Data on the burden of Clostridioides difficile infection (CDI) in Coronavirus Disease 2019 (COVID-19) patients are scant. We conducted an observational, retrospective, multicenter, 1:3 case (COVID-19 patients with CDI)-control (COVID-19 patients without CDI) study in Italy to assess incidence and outcomes, and to identify risk factors for CDI in COVID-19 patients. From February through July 2020, 8402 COVID-19 patients were admitted to eight Italian hospitals; 38 CDI cases were identified, including 32 hospital-onset-CDI (HO-CDI) and 6 community-onset, healthcare-associated-CDI (CO-HCA-CDI). HO-CDI incidence was 4.4 ? 10,000 patient-days. The percentage of cases recovering without complications at discharge (i.e., pressure ulcers, chronic heart decompensation) was lower than among controls (p = 0.01); in-hospital stays was longer among cases, 35.0 versus 19.4 days (p = 0.0007). The presence of a previous hospitalisation (p = 0.001), previous steroid administration (p = 0.008) and the administration of antibiotics during the stay (p = 0.004) were risk factors associated with CDI. In conclusions, CDI complicates COVID-19, mainly in patients with co-morbidities and previous healthcare exposures. Its association with antibiotic usage and hospital acquired bacterial infections should lead to strengthen antimicrobial stewardship programmes and infection prevention and control activities.
Keywords: Clostridioides difficile infection; case-control study; coronavirus disease 2019 pandemic; hospital-onset; risk factors.