P0138 - Examining the Rate of Clostridioides (formerly Clostridium) difficile Infection Pre and Post the COVID-19 Pandemic: An Institutional Review

Simone A. Jarrett, MD¹, Sujani Yadlapati, MD², Kevin Lo, MD¹, Thomas A. Judge, MD^3
1Einstein Healthcare Network, Philadelphia, PA; ²Cooper University Hospital, Camden, NJ; ³Cooper Medical School of Rowan University, Mt. Laurel, NJ

Introduction: Clostridioides difficile infection (CDI) is transmitted via the fecal-oral route and is implicated in antibiotic-associated colitis. Similar to CDI, patients with COVID 19 require early identification and isolation, appropriate personal protective equipment, and environmental disinfection to prevent further transmission. In light of this similarity between isolation and protective requirements to prevent transmission of these diseases, we aim to investigate whether there was a decrease in the incidence of CDI during the peak periods of the COVID 19 pandemic compared to historical rates.

Methods: This is a single center retrospective analysis of the rates of CDI in our institution. The rates of CDI are of reportable hospital acquired infections which is any patient who tests positive for CDI on or after day 3 of hospitalization. COVID-19 time periods were identified from March 2020 to January 2021 and peak periods (with >50 active patients per day) were identified. The non-COVID-19 time periods were July 2017 to February 2020. Rates of CDI were also directly compared across the yearly time period.CDI rates were presented in a per 1000 patient days format. Rates were analyzed per year and during the COVID-19 peaks at our institution. Mann Whitney U test was used to compare rates between 2 time periods while looking at differences across multiple time periods were done using Kruskal Wallis test.

Results: The median(Interquartile Range-IQR) of CDI rates of infection per 1000 patient days for the non-COVID time period from July 2017 to February 2020 was 0.34 (0.23-0.45) while COVID time periods had higher 0.44(0.25-0.51) rates of CDI although this was not statistically significant p=0.224. However, there was a statistically significant difference with COVID peak periods having higher rates of CDI 0.49(0.39-0.74) vs 0.34(0.23-0.44) p=0.036. Overall, there was no statistically significant difference in the rates of CDI across years or time periods p=0.396.

Discussion: There was no difference in the rates of hospital-acquired CDI between COVID-19 and non-COVID-19 time periods at our institution. However, it should be acknowledged that hand washing recommendations for COVID 19 did not strictly rely on soap or water as is needed for CDI as alcohol-based products were also used.




Figure: Figure 1. Median C. difficile infection rates across time periods


Disclosures:
Simone Jarrett indicated no relevant financial relationships.
Sujani Yadlapati indicated no relevant financial relationships.
Kevin Lo indicated no relevant financial relationships.
Thomas Judge indicated no relevant financial relationships.


Simone A. Jarrett, MD¹, Sujani Yadlapati, MD², Kevin Lo, MD¹, Thomas A. Judge, MD³. P0138 - Examining the Rate of Clostridioides (formerly Clostridium) difficile Infection Pre and Post the COVID-19 Pandemic: An Institutional Review, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.