Increase in Clostridioides Difficile Infection Resulting from Over Usage of Antibiotics During COVID 19 Pandemic

Author(s): Sreehari Karunakaran Pillai, Naseem Shuriqy

Healthcare-associated infections (HAIs) due to Clostridioides difficile infections (CDIs) are a significant public health problem globally. The emergence of the novel coronavirus disease (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) in 2019 has exacerbated the situation. Elderly and chronically ill individuals are particularly vulnerable to COVID-19, and gastrointestinal (GI) symptoms are increasingly recognized as essential symptoms of COVID-19. Bacterial infections in COVID-19 patients are prevalent, and the rates of Clostridioides difficile infection (CDI) are high and associated with antibiotic use. The study aims to investigate the correlation between CDI and community antibiotic usage patterns during COVID-19 in 2021 compared to the previous year and subsequent years to identify the impact on overall CDI infection rates. The study design is a non-interventional retrospective study evaluating antibiotic usage patterns in CDI patients during the pandemic, and the data was analysed comparing the number of patients with test positivity rates among the patients admitted to the hospital each year during the study period. The preliminary findings of the study reveal a 27% increase in the number of symptomatic CDI infections in 2021 as compared to pre-COVID years. The incidence of CDI was considerably lower in the subsequent follow up years.