Clostridium difficile Infection Rates During the Pandemic in New York Capital Area: A Single-Center Study

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health

Background:

• Clostridioides difficile (C. difficile) is a bacterium colonizing the large intestine, with antibiotic use being a primary risk factor for infection (CDI).
• The COVID-19 pandemic introduced various risk and protective factors influencing CDI, leading to conflicting findings in previous studies regarding incidence trends.
• A need exists to further analyze CDI incidence rates over an extended period during the pandemic to clarify these trends.

Purpose of the Study:

• To characterize Clostridioides difficile infection (CDI) incidence rate trends over a 22-month period during the COVID-19 pandemic.
• To compare CDI incidence rates during the pandemic period (March 2020 - December 2021) with the pre-pandemic era (January 2018 - February 2020).

Main Methods:

• Inclusion of adult patients hospitalized and diagnosed with CDI between January 1, 2018, and December 31, 2021.
• Calculation of CDI incidence as cases per 10,000 patient-days.
• Statistical analysis comparing incidence rates before and during the defined COVID-19 pandemic period.

Main Results:

• The overall mean CDI incidence rate was 6.86 +/-2.1 cases per 10,000 patient-days.
• The pre-pandemic incidence rate was 5.67 +/-0.35 per 10,000 patient-days.
• The incidence rate during the pandemic significantly increased to 8.06 +/-0.41 per 10,000 patient-days.

Conclusions:

• Despite conflicting literature, this study demonstrates a statistically significant rise in CDI incidence rates during the COVID-19 pandemic.
• The findings highlight the impact of the pandemic on hospital-acquired infections, specifically CDI.
• Extended analysis over an almost two-year pandemic period confirms an increase in CDI rates compared to pre-pandemic levels.