Epidemiološke i kliničke karakteristike Clostridium difficile infekcije prije i tokom COVID-19 pandemije

Epidemiological and clinical characteristics of Clostridium difficile infections

  • Darija Knežević Medicinski fakultet Univerzitet u Banjoj Luci
  • Duška Jović University of Banja Luka, Faculty of Medicine
  • Miroslav Petković University of Banja Luka, Faculty of Medicine
Ključne reči: Clostridium difficile infekcije, COVID-19, Faktori rizika, Izbijanje bolesti

Sažetak


Background/Aim: Diarrhoea that occurs as a result of the presence of Clostridium

difficile (reclassified as Clostridoides difficile) is usually manifested as a hospital

infection, usually after antibiotic treatment. The study aim was to assess

the incidence, characteristics and outcomes of hospitalised patients with healthcare

– associated Clostridioides difficile infection ( HA - CDI) before and during

the COVID-19 pandemic.

Methods: This retrospective cohort study included patients older than 18, who

met the HA - CDI case definition. The CDI diagnosis was made by demonstrating

toxins A and B in stool samples using an immunochromatographic assay test

and polymerase chain reaction (PCR).

Results: The incidence of HA - CDI has significantly decreased from the pre-

COVID-19 period to the COVID-19 period (11.04 per 10,000 vs 6.49 per 10,000,

p < 0.001). Before establishing the HA - CDI diagnosis, 41.4 % of patients used

one antibiotic, 25.9 % used two and 11.2 % were treated with three or more

antibiotics. Almost one half of the applied antibiotics were from the group that

represents high risk for the development of HA - CDI. Multivariable logistic regression

analysis showed that older age (OR = 3.4; 95 % CI = 0.9-12.4; p = 0.038)

and complicated disease course (OR = 11.8; 95 % CI = 2.6-53.6; p ≤ 0.001) were

associated with a higher risk of death.

Conclusion: The incidence of HA - CDI has decreased during the observed period

of the COVID-19 pandemic, however, no clear connection between the impact

of the pandemic and incidence reduction was found. Due to unfavourable

outcome of the treatment of HA - CDI patients during COVID-19 pandemic, the

rational use of antibiotics is necessary.

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2023/03/30
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