Unidad de Enfermedades Infecciosas y Microbiología, Hospital Universitario de Valme, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Sevilla, Spain.
Servicio de Medicina Preventiva, Hospital General Universitario de Alicante, Instituto de Investigación Biomédica de Alicante (ISABIAL), Alicante, Spain.
Anaerobe. 2022 Jun;75:102579. doi: 10.1016/j.anaerobe.2022.102579. Epub 2022 Apr 30.
To investigate the impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection (HA-CDI).
Retrospective study conducted in the Hospital Universitario de Valme (HUV) and the Hospital General Universitario de Alicante (HGUA) in Spain between January 2019 and February 2021. The study period was divided into non-COVID19 period (2019 and months from 2020 to 2021 with ≤30 hospitalized COVID19 patients) and COVID19 period (months from 2020 to 2021 with >30 COVID19 patients). HA-CDI incidence rates (IR) were calculated as the number of new CDI cases per 10.000 occupied bed-days (OBD) and antimicrobial consumption by means of the defined daily dose (DDD) per 1000 OBD.
During the COVID19 period, HA-CDI IR in the HUV was 2.6 per 10.000 OBD, which was lower than what was observed during the non-COVID19 period (4.1 per 10.000 OBD; p = 0.1). In the HGUA, HA-CDI IR during COVID19 period was 3.9 per 10.000 OBD, which was not significantly different to the IR observed during the non-COVID19 period (3.7 per 10.000 OBD; p = 0.8). There was a slight increase in the total antibiotic consumption during COVID19 period in both hospitals, with significant increases of certain high-risk antibiotics as cephalosporins.
HA-CDI incidence has not increased during the COVID19 pandemic in two tertiary centers in Spain, in spite of a slightly higher antibiotic consumption during the COVID19 period in both hospitals. These findings suggest that, in the presence of strict infection control measures, hospital antibiotic consumption might have a lower impact than expected on HA-CDI.
研究 COVID19 大流行对卫生保健相关艰难梭菌感染（HA-CDI）发病率的影响。
本研究在西班牙的瓦尔梅大学医院（HUV）和阿利坎特综合大学医院（HGUA）进行，时间为 2019 年 1 月至 2021 年 2 月。研究期间分为非 COVID19 期（2019 年以及 2020 年至 2021 年期间住院 COVID19 患者≤30 例的月份）和 COVID19 期（2020 年至 2021 年期间住院 COVID19 患者>30 例的月份）。HA-CDI 发病率（IR）按每 10000 个占用病床日（OBD）新发生 CDI 病例数和每 1000 OBD 定义日剂量（DDD）计算抗菌药物消耗量。
在 COVID19 期间，HUV 的 HA-CDI IR 为 2.6/10000 OBD，低于非 COVID19 期间（4.1/10000 OBD；p=0.1）。在 HGUA，COVID19 期间的 HA-CDI IR 为 3.9/10000 OBD，与非 COVID19 期间的 IR 无显著差异（3.7/10000 OBD；p=0.8）。两个医院在 COVID19 期间总抗生素消耗量略有增加，某些高风险抗生素（如头孢菌素）的用量显著增加。
在西班牙的两个三级中心，尽管 COVID19 期间两个医院的抗生素用量略有增加，但 HA-CDI 的发病率并未在 COVID19 大流行期间增加。这些发现表明，在严格的感染控制措施下，医院抗生素的使用量对 HA-CDI 的影响可能比预期的要小。
