ABSTRACT
Background and Aim Clostridioides difficile infection (CDI) is the leading cause of hospitalacquired infectious diarrhoea. High bed occupancy rates in acute hospitals correlate with an increased incidence of healthcare-associated CDI (HA-CDI). The COVID-19 pandemic led to changes within our healthcare system, including cessation of elective procedures and reduced presentations for non-COVID-19-related illnesses. Our aim was to determine if improved hand-hygiene, increased use of personal protective equipment (PPE), social distancing and reduced hospital occupancy observed during the first wave of the COVID-19 pandemic also impacted on rates of HA-CDI. Methods: We defined the COVID-19 outbreak period as March to May 2020 and identified newly-acquired HA-CDI cases during the same periods in 2018, 2019 and 2020, using the hospital C. difficile database. HA-CDI was defined as per national case definitions. Electronic records were used to assess patient demographics and biochemical markers. Hospital antimicrobial consumption and hand-hygiene audit data for the study period and corresponding in 2018, 2019 and 2020 were collected. Statistical analysis was performed using STATA. Results Fifty patients with HA-CDI were identified. Chi-squared analysis with Yates correction demonstrated a decrease in newly-acquired HACDI during the first wave of the COVID-19 pandemic period when compared to the same period in 2018 and 2019 (p=0.029);(Table 1). Conclusion During the first wave of the COVID-19 pandemic, static antimicrobial use, reduced hospital occupancy, improved hand hygiene and the use of PPE resulted in a decline in HA-CDI;demonstrating the importance of hospital activity and infection prevention and control measures on HA-CDI during an inpatient stay. (Table presented)