Previously submitted to: Interactive Journal of Medical Research (no longer under consideration since Jun 25, 2025)
Date Submitted: Jan 5, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Incidence of Hospital-Acquired Toxin-Producing Clostridioides difficile Infection Between the Pre-Pandemic (2017–2019) and Pandemic (2020–2022): A Retrospective Cohort Study
ABSTRACT
Background:
In 2020, the World Health Organization (WHO) declared SARS-CoV-2 a global public health emergency, driving healthcare systems worldwide to reorganize activities and adopt stringent infection prevention protocols. Among nosocomial infections, toxin-producing Clostridioides difficile infection (TCDI) remains a significant concern in hos-pitalized patients, primarily transmitted through contact. Efforts to mitigate TCDI fo-cus on minimizing in-hospital bacterial transmission, as the infection control measures implemented during the pandemic.
Objective:
Objective:
to evaluate the incidence of nosocomial TCDI during the pandemic, compar-ing the impact of non-pharmacological measures implemented during this period with prior years and identify associations between risk factors in these periods.
Methods:
A retrospective observational cohort study was conducted at A Coruña University Hos-pital from 2017 to 2022. Patients were categorized into pre-pandemic (2017-2019) or pandemic (2020-2022) groups based on nosocomial TCDI criteria. Descriptive analyses evaluated age, sex, antibiotic use, and comorbidities. Incidence rates were calculated, and risk factor associations were analyzed for both periods.
Results:
The study identified 249 nosocomial TCDI cases: 89 pre-pandemic and 160 during the pandemic, reflecting a 79.8% increase. Patients hospitalized during the pandemic faced a 92% greater risk of TCDI (RR=1.92, p=0.001). The incidence density of TCDI during the pandemic years was 1.44 CDI/10,000 patient-days Predisposing factors in-cluded solid organ neoplasms (pre-pandemic 33.7%; pandemic 33.1%), secondary im-munosuppression (pre-pandemic 31.5%; pandemic 40.6%).
Conclusions:
In conclusion, despite implementing precautionary measures, nosocomial TCDI inci-dence increased during the pandemic. Understanding the factors contributing to TCDI acquisition in hospitalized patients is crucial for designing effective preventive inter-ventions and strategies Clinical Trial: not a clinical trial
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