Healthcare-associated Clostridioides difficile infection during the COVID-19 pandemic in a tertiary care hospital in Romania.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL
Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI:10.2478/rjim-2021-0020
Eliza Manea, Raluca Jipa, Alexandru Milea, Antonia Roman, Georgiana Neagu, Adriana Hristea
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引用次数: 9

Abstract

Introduction. Information on healthcare-associated C.difficile infection (HA-CDI) in COVID-19 patients is limited. We aimed to assess the characteristics of HA-CDI acquired during and before the COVID-19 pandemic. Methods. We conducted a retrospective study in a tertiary care hospital, in which since March 2020 exclusively COVID-19 patients are hospitalized. We compared HA-CDI adult patients hospitalized in March 2020-February 2021 with those hospitalized during the same period in 2017-2018. Results. We found 51 cases during 2020-2021 (COVID-19 group), incidence 5.6/1000 adult discharge and 99 cases during 2017-2018 (pre-COVID-19 group), incidence 6.1/1000 adult discharge (p=0.6). The patients in COVID-19 group compared to pre-COVID-19 group were older (median age 66 vs 62 years), with similar rate of comorbidities, but with higher rate of cardiovascular diseases (62.7% vs 42.4%) and less immunosuppression (21.6% vs 55.6%), they had a higher proton pump inhibitors use (94.1% vs 32.3%), and a longer hospitalization (median 19 vs 14 days). Eighty-five (85.9%) patients in pre-COVID-19 group versus 44 (86.3%) patients in COVID-19 group received antimicrobial treatment - mainly cephalosporins (34,1%), quinolones (22,3%) and glycopeptides (21,1%) in pre-COVID-19 group and mainly cephalosporins and macrolides (63,6% each) in COVID-19 group. We found four HA-CDI-related deaths in pre-COVID-19 group and none in the COVID-19 group. Conclusions. The HA-CDI incidence in COVID-19 group did not change versus the same period of time during 2017-2018. The antibiotic use was the most important factor associated with HA-CDI. We identified a high use of broad-spectrum antibiotics despite the lack of empirical antimicrobial recommendations in COVID-19.

罗马尼亚一家三级保健医院COVID-19大流行期间与医疗保健相关的艰难梭菌感染
介绍。关于COVID-19患者中与医疗保健相关的艰难梭菌感染(HA-CDI)的信息有限。我们的目的是评估在COVID-19大流行期间和之前获得的HA-CDI的特征。方法。我们在一家三级保健医院进行了回顾性研究,该医院自2020年3月以来只住院了COVID-19患者。我们比较了2020年3月- 2021年2月住院的HA-CDI成人患者与2017-2018年同期住院的患者。结果。我们发现2020-2021年(COVID-19组)51例,发病率5.6/1000成人出院;2017-2018年(COVID-19前期组)99例,发病率6.1/1000成人出院(p=0.6)。与COVID-19前组相比,COVID-19组患者年龄较大(中位年龄66岁对62岁),合合症发生率相似,但心血管疾病发生率较高(62.7%对42.4%),免疫抑制较少(21.6%对55.6%),质子泵抑制剂使用率较高(94.1%对32.3%),住院时间较长(中位19天对14天)。前期组85例(85.9%)患者接受了抗菌药物治疗,而COVID-19组44例(86.3%)患者接受了抗菌药物治疗,其中前期组以头孢菌素类药物(34.1%)、喹诺酮类药物(22.3%)和糖肽类药物(21.1%)为主,COVID-19组以头孢菌素类药物和大环内酯类药物(63.6%)为主。我们发现在COVID-19前组中有4例ha - cdi相关死亡,而COVID-19组中没有死亡。结论。与2017-2018年同期相比,COVID-19组HA-CDI发病率没有变化。抗生素使用是与HA-CDI相关的最重要因素。我们发现,尽管在COVID-19中缺乏经验性抗菌药物建议,但广谱抗生素的使用率很高。
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来源期刊
Romanian Journal of Internal Medicine
Romanian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
5.30%
发文量
35
审稿时长
15 weeks
期刊介绍: Romanian Journal of Physics is a journal publishing physics contributions on the following themes: •Theoretical Physics & Applied Mathematics •Nuclear Physics •Solid State Physics & Materials Science •Statistical Physics & Quantum Mechanics •Optics •Spectroscopy •Plasma & Lasers •Nuclear & Elementary Particles Physics •Atomic and Molecular Physics •Astrophysics •Atmosphere and Earth Science •Environment Protection
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