The Burden of Clostridioides Difficile Infection during the COVID-19 Pandemic: A Retrospective Case-Control Study in Italian Hospitals (CloVid)

Guido Granata, Alessandro Bartoloni, Mauro Codeluppi, Ilaria Contadini, Francesco Cristini, Massimo Fantoni, Alice Ferraresi, Chiara Fornabaio, Sara Grasselli, Filippo Lagi, Luca Masucci, Massimo Puoti, Alessandro Raimondi, Eleonora Taddei, Filippo Fabio Trapani, Pierluigi Viale, Stuart Johnson, Nicola Petrosillo

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalJournal of Clinical Medicine
Volume9
Issue number12
DOIs
Publication statusPublished - Nov 27 2020

Fingerprint

Dive into the research topics of 'The Burden of Clostridioides Difficile Infection during the COVID-19 Pandemic: A Retrospective Case-Control Study in Italian Hospitals (CloVid)'. Together they form a unique fingerprint.

Cite this