Lang Kaiting, Atchison T J, Singh Priti, Kline David M, Odei James B, Martin Jennifer L, Smyer Justin F, Day Shandra R, Hebert Courtney L
Division of Epidemiology, College of Public Health, Columbus, Ohio.
College of Medicine, The Ohio State University, Columbus, Ohio.
Infect Control Hosp Epidemiol. 2024 Mar;45(3):329-334. doi: 10.1017/ice.2023.171. Epub 2023 Oct 9.
To assess the relative risk of hospital-onset (HO-CDI) during each month of the early coronavirus disease 2019 (COVID-19) pandemic and to compare it with historical expectation based on patient characteristics.
This study used a retrospective cohort design. We collected secondary data from the institution's electronic health record (EHR).
The Ohio State University Wexner Medical Center, Ohio, a large tertiary healthcare system in the Midwest.
All adult patients admitted to the inpatient setting between January 2018 and May 2021 were eligible for the study. Prisoners, children, individuals presenting with on admission, and patients with <4 days of inpatient stay were excluded from the study.
After controlling for patient characteristics, the observed numbers of HO-CDI cases were not significantly different than expected. However, during 3 months of the pandemic period, the observed numbers of cases were significantly different from what would be expected based on patient characteristics. Of these 3 months, 2 months had more cases than expected and 1 month had fewer.
Variations in HO-CDI incidence seemed to trend with COVID-19 incidence but were not fully explained by our case mix. Other factors contributing to the variability in HO-CDI incidence beyond listed patient characteristics need to be explored.
评估2019冠状病毒病（COVID-19）大流行早期各月份医院获得性艰难梭菌感染（HO-CDI）的相对风险，并根据患者特征将其与历史预期进行比较。
本研究采用回顾性队列设计。我们从该机构的电子健康记录（EHR）中收集了二手数据。
俄亥俄州立大学韦克斯纳医学中心，位于俄亥俄州，是中西部的一个大型三级医疗系统。
2018年1月至2021年5月期间入住住院病房的所有成年患者均符合本研究条件。囚犯、儿童、入院时出现[此处原文缺失相关内容]的个体以及住院时间<4天的患者被排除在研究之外。
在控制患者特征后，观察到的HO-CDI病例数与预期无显著差异。然而，在大流行期间的3个月里，观察到的病例数与基于患者特征的预期有显著差异。在这3个月中，有2个月的病例数多于预期，1个月的病例数少于预期。
HO-CDI发病率的变化似乎与COVID-19发病率呈趋势性，但我们的病例组合并未完全解释这种变化。需要探索除所列患者特征之外导致HO-CDI发病率变异性的其他因素。
