Brief ReportTrends in Clostridioides difficile infection across a public health hospital system in New York City 2019-2021: A cautionary note
Section snippets
Methods
Data was obtained from National Hospital Safety Network (NHSN) for 11 hospitals belonging the NYC Health + Hospital Enterprise, as previously reported.4 All 11 hospitals are academic, tertiary care, major medical centers. While there are centralized policies, all have their own designated administration, antibiotic stewardship program and clinical staff. A small subset of patients may be referred from one facility to another for specialized services (eg, cardiothoracic surgery). Line listings
Results
From 2019Q1 through 2020Q1, there were progressive declines in the number of patients with healthcare facility-onset C. difficile and standardized infection ratios (SIRs) for the 11-hospital system (Fig 1). However, in the spring of 2020, this trend was reversed. Segmented regression analysis revealed a marked increase (P = .085) in rates at the breakpoint 2020Q2. Approximately one-third of cases with C. difficile in 2020Q2 were in patients with COVID-19. For the following year after the surge,
Discussion
Contrary to national reports,2,3 we observed an increase in healthcare facility-onset C. difficile infections following the initial surge of COVID-19 in NYC hospitals. A marked increase in cephalosporin usage coincided with the initial surge; usage continued to remain above baseline for the subsequent months. In 1 report elevated rates of C. difficile among patients with COVID-19 were attributed to greater healthcare exposure and antibiotic use.5 In our study, during the initial surge
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Cited by (3)
Carbapenem-Resistant Klebsiella pneumoniae in Large Public Acute-Care Healthcare System, New York, New York, USA, 2016-2022
2023, Emerging Infectious DiseasesMedical Big Data and Artificial Intelligence for Healthcare
2023, Applied Sciences (Switzerland)
Conflicts of interest: None to report.