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Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
Published on: December 10, 2016
Our experience with 80 cases of SARS-CoV-2-Clostridioides difficile co-infection: An observational study
Victoria Birlutiu1, Elena Simona Dobritoiu1, Claudia Daniela Lupu1
1Faculty of Medicine Sibiu, Lucian Blaga University of Sibiu, Academic Emergency Hospital Sibiu-Infectious Diseases Clinic, Sibiu, Romania. Sibiu, Romania.
Abstract:
Beside the changes in the gut microbiota in context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the increased use of high-risk broad-spectrum antibiotics during the actual pandemic raises concerns about a possible increase of Clostridioides difficile infections (CDIs). We retrospectively analyzed 80 consecutive patients, with SARS-CoV-2 pneumonia and CDI. The mean length of hospitalization was 19.63 days. The mean time of the onset of the digestive symptoms related to CDI was 5.16 days. Patients with an onset of the digestive symptoms from hospital admission have a significantly lower median length in hospital stay. The recovered patients present a statistically significant decreased median age. coronavirus disease 2019 (COVID-19) cured patients present CDI symptoms much earlier than the deceased patients, when comparing the median days before the occurrence of any digestive symptoms regarding CDI. Among the patients that prior to their hospitalization for COVID-19 were exposed to antibiotics, 54.7% presented CDI digestive symptoms during their hospitalization and 65.6% had a severe or critical COVID-19 form. Although the incidence of CDI in the pandemic is lower compared to the period before the pandemic, the severity of cases and the death rate increased. In the actual setting clinicians need to be aware of possible CDI and SARS-CoV-2 co-infection.
Insights
The study found that while Clostridioides difficile infections (CDIs) were less common during the COVID-19 pandemic, cases were more severe and had higher mortality rates. Early CDI symptom onset correlated with shorter hospital stays.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Background:
- The COVID-19 pandemic saw increased antibiotic use, raising concerns about secondary infections like Clostridioides difficile infections (CDIs).
- SARS-CoV-2 infection alters gut microbiota, potentially increasing susceptibility to CDIs.
- Understanding the interplay between SARS-CoV-2 and CDI is crucial for patient management.
Purpose of the Study:
- To investigate the characteristics and outcomes of patients with concurrent SARS-CoV-2 pneumonia and Clostridioides difficile infections.
- To assess the impact of CDI on hospitalization duration and severity in COVID-19 patients.
Main Methods:
- Retrospective analysis of 80 patients with SARS-CoV-2 pneumonia and CDI.
- Data collected included hospitalization length, time to CDI symptom onset, patient demographics, and COVID-19 severity.
- Comparison of outcomes based on timing of CDI symptoms and prior antibiotic exposure.
Main Results:
- The mean hospitalization stay was 19.63 days, with CDI symptoms appearing a median of 5.16 days after admission.
- Patients with earlier CDI symptom onset had significantly shorter hospital stays.
- Recovered patients were significantly younger.
- Antibiotic-exposed patients had higher rates of CDI symptoms and severe/critical COVID-19.
- Despite lower incidence, CDI cases during the pandemic showed increased severity and mortality.
Conclusions:
- Clinicians must remain vigilant for CDI in patients hospitalized with SARS-CoV-2, especially those with prior antibiotic exposure.
- Concurrent CDI significantly impacts COVID-19 patient outcomes, increasing severity and mortality.
- Early recognition and management of CDI are vital in the context of SARS-CoV-2 infection.
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12:58A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
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