RATES OF HOSPITAL-ACQUIRED CLOSTRIDIOIDES INFECTION DURING THE COVID-19 PANDEMIC IN A TERTIARY HEALTHCARE SETTING

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)