Clostridioides difficile infection in patients with COVID-19 pneumonia - Analysis of occurrence and genetic distribution from three intensive care units.

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) pandemic challenged several of the well-known routines to prevent Clostridioides difficile infection (CDI) in intensive care units (ICUs). There are limited data evaluating CDI in ICU patients with COVID-19 pneumonia and acute respiratory distress syndrome. The objective of this study was to determine the occurrence of CDI and possible transmission of C. difficile within three ICUs in patients with COVID-19 pneumonia.

METHODS

A retrospective analysis was conducted on all patients with confirmed COVID-19 pneumonia treated in the ICU between March 14, 2020 and July 31, 2021. All patients were assessed for the presence of diarrhoea, as well as for positive C. difficile antigen analysis. C. difficile isolates underwent high molecular weight (HMW) typing and whole genome sequencing (WGS) for the assessment of transmission.

RESULTS

A total of 343 patients were treated in the ICUs during the study period. Diarrhoea was observed in 219 (63.8 %) patients, and 8 patients (2.3 %) were diagnosed with CDI. No evidence of transmission between patients was seen.

CONCLUSION

This study reveals a low occurrence of CDI in ICU patients with COVID-19 pneumonia. WGS was superior to HMW-typing in evaluating potential transmission.