Impact of the COVID-19 pandemic on the incidence of healthcare-associated Clostridioides difficile infection in a tertiary healthcare facility in the Republic of Ireland

Abstract

Clostridioides difficile is the foremost cause of nosocomial infectious diarrhoea and one of the most prevalent healthcare associated infections (HAIs). To investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of healthcare associated C.difficile infection (HA-CDI). A retrospective study was conducted from January 2019-December 2022 inclusive at a tertiary University Hospital in Dublin, Ireland. The study period was divided into COVID-19 and non-COVID-19 periods determined in tangent with the then national incidences of COVID-19 and number of hospitalized patients with COVID-19. Analyses looked at quantity of testing performed, incidence rates and antimicrobial consumption. An independent samples t-test was used to determine significance between groups. Between COVID-19 and non-COVID-19 periods, no statistically significant difference was observed among HA-CDI rates per 10,000 bed-days (2.1 cases vs 1.76 cases; P=0.34), consumption of defined daily doses per 100 bed-days of antimicrobials - all antimicrobials (83.36 vs 89.5; P=0.091), fluoroquinolones only (3.71 vs 4.46; P=0.067), third-generation cephalosporins only (4.17 vs 4.43; P=0.449), carbapenems only (3.28 vs 3.26; P=0.944) - or the number of C.difficile tests performed per 10,000 bed-days (321.81 tests vs 326.63 tests; P=0.696). There was no difference in the incidence rates of HA-CDI between COVID-19 and non-COVID-19 periods at our institution.